განვითარების ფსიქოლოგია

2
რიდერი

თბილისი
2021
 დისციპლინის თემატური შინაარსი

თემა 1. მოწიფულობა _ ზოგადი დახასიათება: ბიოლოგიური, სოციალური და ფსიქოლოგიური

ასაკის ცნება; ზრდასრული ადამიანის განვითარების ამოცანები; ოჯახური ერთიერთობებისა და
პროფესიული განვითარების ციკლები. გვ;3-11

თემა 2. მოწიფულობის ადრეული ხანა :ფიზიკური განვითარება და ჯანმრთელობა; ფორმალური

ოპერაციების მიღმა (სტუდენტური აზროვნების "სტადიები"); განვითარების ამოცანები; კოგნიტური
განვითარება და მე-სგანვითარება (ლოვინგერი, კაგანი); იდენტობა, სიახლოვე და გენერატიულობა
(ადამიანი ოჯახში და სამსახურში). გვ;11-21

თემა 3. მოწიფულობა:

• ფიზიკური და კოგნიტური განვითარება :ფიზიკური განვითარება: ცვლილებები სენსო-

მოტორულ სფეროში, მენოპაუზა; ჯანმრთელობა, სტრესი, დაავადებები. ზრდასრული
ადამიანის ინტელექტის სტადიები (შაიე); კოგნიტური უნარების განვითარება (მიმდინარე და
კრისტალიზებული ინტელექტი);

• ფსიქო-სოციალური განვითარება (ოჯახის ციკლი):სიახლოვე (სიყვარული, პარტნიორის არჩევა,

ქორწინება, თანაცხოვრება); მარტოხელა ადამიანები;საშუალო ასაკის ამოცანები _ გენდერული
თავისებურებები;

• ფსიქო-სოციალური განვითარება (მშობლის როლი და ფუნქცია):ოჯახის ციკლი (მშობლის

როლი, ბავშვების აღზრდა, მარტოხელა მშობლები); ინტერპერსონალური ურთიერთობები
ოჯახში და სოციუმში; განქორწინება და მისი შედეგები;

• ფსიქოსოციალური განვითარება (პროფესიული განვითარების ციკლი): პროფესიული ციკლი

(პროფესიის არჩევა, პროფესიული ადაპტაცია, კარიერის ეტაპები, გენდერული სხვაობები).
ცვლილებები პროფესიულ საქმიანობაში (კარიერის გადაფასება, სამუშაოს გამოცვლა ან
დაკარგვა, სტრესი სამსახურში და "პროფესიული გადაწვა");

• ფსიქოსოციალური განვითარება (გენდერული სხვაობები პროფესიულ

განვითარებაში):გენდერული სხვაობა პროფესიული კარიერის განვითარებაში. გვ;21-69

თემა4. ხანდაზმულობა
• პერიოდიზაცია:დაბერების მიზეზები და ფიზიკური ასპექტები (ჯანმრთელობა და
დაავადებები);განვითარების ამოცანები ხანდაზმულობის პერიოდში; ხანდაზმულობის
საფეხურის პერიოდები;
• ფიზიკური და კოგნიტური განვითარება ცხოვრების სტილი და ჯანმრთელობა; ცვლილებები
კოგნიტურ უნარებში (აღქმა, ყურადღება, მეხსიერება, აზროვნება, მეტყველება);
აზროვნებისა და მეხსიერების პრობლემები (დემენცია _ ათეროსკლეროზი, ალცჰეიმერის
დაავადება);
• ფსიქოსოციალური განვითარება (პროფესიული საქმიანობა, ინტერპერსონალური
ურთიერთობები)პენსიაზე გასვლა; ოჯახური და ინტერპერსონალური ურთიერთობები;

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 • ფსიქოსოციალური განვითარება (ოჯახი და გენერატიულობა)დამოკიდებულება
ხანდაზმულებისადმი (სოციალური პოლიტიკა, კულტურალური სხვაობები,
სტერეოტიპები, დისკრიმინაცია).გ;70-106

თემა 5. ცხოვრების დასასრული.ქვრივობა (მწუხარება და დანაკარგთან შეგუების პროცესი;

სიკვდილი, როგორც განვითარების ბოლო საფეხური და მასთან შეგუების სტადიები.ადამიანის
ცხოვრების გზის განვითარების შესწავლის პერსპექტივები.გვ;107-172

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Tema 1. mowifuli da xandazmuli adamianebis ganviTarebis kvlevis
Taviseburebebi:

mowifulobis periodi adamianis cxovrebis 3/4-s ikavebs. Cveulebriv,

mas yofen sam qveperiodad an stadiad: adreuli (20-40 weli), saSualo (40-
60 ww) da gviani (60 da zeviT) mowifuloba.

bavSvoba mowifuloba

adreuli saSualo gviani adreuli saSualo gviani

(skolam.) (dawy.) mozardoba studentoba "Segirdoba"

1 - - - - 6 - - - - - 12 - - - - - 18 - - - - - 24 - - - - 30 - - -36 - - - 42 - - - 48 - - - 52 - - - 60

xandazmuloba

adreuli saSualo gviani

60 - - - - - 66 - - - - - 72 - - - - - 78 - -- - - 84 - - - - - 90 - - - - - 96 - - - - - 100

asakis gansazRvreba.
mniSvnelovania gaviTvaliswinoT, rom TavisTavad qronologiuri
asaki nakleb informatulia. individis biologiuri, fsiqologiuri da
socialuri asaki ganixileba rogorc sami damoukidebeli cneba.
biologiuri asaki _ adamianis cxovrebis saSualo xangrZlivoba
mniSvnelovnad icvleba individebSi. biologiuri asaki 40 wlis mamakacis,
romelsac guli aqvs daavadebuli da ramdenime wlis sicocxle aqvs
darCenili sul sxvaa, vidre 40 wlis janmrTeli mamakacisa, romelsac
kidev 35 wlis sicocxlis imedi aqvs.
biologiuri asaki _ es aris organizmis morfologiuri da
fiziologiuri ganviTareba. ratom gaxda saWiro am cnebis damkvidreba?
kalendaruli (qronologiuri, pasportis) asaki ar aris sakmarisi
adamianis janmrTelobisa da Sromisunarianobis gansazRvrisTvis.
erTi asakis adamianebs Soris Cveulebriv mniSvnelovani gansxvavebaa.
gansvla adamianis qronologiur da biologiur asakebs Soris
saSualebas gvaZlevs ganvsazRvroT daberebis intensivoba da adamianis
funqcionaluri SesaZleblobebi. aseTi cvlilebebi SedarebiT neli
tempiT midis axalgazrdebSi da yvelaze Cqara xandazmulebSi.

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 biologiuri asaki, memkvidreobiTobis garda, damokidebulia garemo
pirobebze da cxovrebis stilze. amitom cxovrebis meore naxevarSi
erTidaigive asakis adamianebi SeiZleba sakmaod gansxvavdeboden
biologiuri asakiT. SedarebiT axalgazrdebi arian xolme is adaminebi,
romelTac aqvT kargi memkvidreoba da SedarebiT jansaRi cxovrebis
stili.
biologiuri asakis gansazRvris meTodi: arterialuri wneva,
filtvebis sasicocxlo tevadoba, ; mxedveloba, smena, yuradRebis
gadatanis siswrafe, motoruli aparati; jansaRi kbilebis raodenoba.
gaTvaliswinebuli unda iyos sqesi, individualuri da konstituciuri
Taviseburebebi, socialuri faqtorebis gavlena da sxv.
jansaRi cxovrebis wesi gavlenas axdens biologiur asakze. misi
Semcireba, stabilizacia an Seneleba niSnavs daberebis Senelebas.
yvelaze gadamwyveti aris fsiqologiuri faqtori _ survili daxarjo
amaze Zala, dro da Tanxebi.
gerontologebi Tvlian, rom qalebi ufro nela berdebian da
cxovroben 6-8 wliT mets. qalebis meti sicocxlisunarianoba SeimCneva
mTeli cxovrebis manZilze. arsebobs aseve socialur-fsiqologiuri
mizezebis mTeli rigi, romlebic sxvadasxvanairad axdenen gavlenas
sqesTa sicocxlis xangrZlivobaze. qalebisTvis dadebiTi socialuri
faqtorebia seqsualuri cxovrebiT kmayofileba, ojaxisa da Svilebis
yola. mamakacebisTvis ki mniSvnelovania _ kmayofileba karieriT.
socialuri asaki fasdeba imis mixedviT ramdenad Seesabameba
individis mdgomareoba mocemuli kulturis normebs. 50 wlis
daqorwinebul mamakacs 3 SviliT uyureben sul sxvanairad, vidre 50 wlis
martoxela kacs, romelic barebSi cdilobs partniorebis gacnobas.
fsiqologiuri asaki migvaniSnebs imaze, Tu ramdenad adaptirebulia
adamiani garemosadmi. is moicavs inteleqtis dones, daswavlis unars,
motorul Cvevebs da iseT subieqtur faqtorebs, rogoricaa grZnobebi,
ganwyobebi da motivebi.
am faqtorebis erTianobas gulisxmobs mowifulobis cneba.
marTalia, biologiuri da socialuri faqtorebi aris aucilebeli
pirobebi zrdasrulobis misaRwevad (magaliTad, garkveuli asaki da
socialuri statusi), zrdasrulobis ganmsazRvreli aris garkveuli
fsiqologiuri Tvisebebic: materialuri da socialuri damoukidebloba
da avtonomia, gadawyvetilebebis damoukideblad miRebis unari da
garkveuli xarisxiT xasiaTis simtkice, keTilgoniereba, sandooba,
patiosneba da TanagrZnobis unari. Tumca mkveTri asakobrivi sazRvrebis
dadgena samive TvalsazrisiT SeuZlebelia.

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 jefri jensen arnetis azriT, aris 5 maxasiaTebeli, romelic
ganasxvavebs mowifulobis gardamaval periods cxovrebis sxva
safexurebisgan: identobis Zieba, arastabiluroba, gaurkvevlobis gancda,
da farTo SesaZleblobebis SegrZneba. am xuTidan oTx maxasiaTebels
eTanxmeba arnetis gamokvlevaSi 18-29 wlis cdispirebis umravlesoba.

mexuTe maxasiaTebeli, gaurkvevlobis gancda, dadginda kiTxvebiT:

“grZnob, rom miaRwie mowifulobas?” da cdispirebs pasuxi unda aerCiaT:
“ki”, “ara”, “zogjer ki, zogjer _ ara”. 49%-ma upasuxa “ki”, 5%-ma “ara” da
47%-ma “zogjer ki, zogjer ara”. “gaurkveveli mdgomareobis
mimaniSnebelia pasuxi “zogjer ki, zogjer ara”. am pasuxis raodenoba
mcirdeba asakTan erTad, 18-21 wlianebTan iyo 60%, 22-25 wlianebTan
Camovida 41%-mde da 26-29 wlianebTan _ 30%-mde.

urTierTobebi mSoblebTan. mowifulobis gardamaval periodSi

myofi adamianebi da maTi mSoblebi zogadad kargad cxovroben.
gardamaval periodSi myofi adamianebis naxevarze meti (55%) ambobs, rom
kontaqtSi arian Tavis mSoblebTan “yoveldRe an TiTqmis yoveldRe”,
saubroben axlo urTierTobebze mSoblebTan. amas xels uwyobs
Tanamedrove teqnologiebi romelic ukve yvelgan aris (da iafic Rirs).
daaxlovebiT sami meoTxedi (78%) ambobs, rom cxovroben Tavis
mSoblebTan axla ukeTesad, urTierTobebi gaumjobesda vidre iyo
mozardobis Sua periodSi (14-17 ww).

gavrcelebuli Sexedulebisgan gansxvavebiT, rom mSoblebs ar surT maTi

gardamaval periodSi myofi Svilebi saxlSi rom cxovrobdnen, mSoblebis
61%-is damokidebuleba iyo “metwilad pozitiuri” da mxolod 6%-sa
“metwilad negatiuri” viTarebaze, roca maTi 18-29 wlis Svili cxovrobs
saxlSi an dabrunda saxlSi. mSoblebis daaxlovebiT 67% ambobs, rom
ukve wamozrdili Svilebis maTTan cxovrebis Sedegi isaa, rom axla
emociurad ufro met siaxloves grZnoben maTTan, da 66% aRniSnavs, rom
meti amxanaguri urTierToba aqvs SvilTan. umravlesoba (62%) aseve
ambobs, rom wamozrdili Svili exmareba saxlis saqmeebSi. magram
yvelaferi kargad araa, roca wamozrdili Svili mSoblebis saxlSi
cxovrobs: mSoblebis 40% aRniSnavs, rom mSoblebis saxlSi cxovrebis
Sedegi maTi SvilebisTvis aris is, rom mSoblebs aqvT meti finansuri
sirTuleebi. Developmental Psychologist | July 2013

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zrdasruli adamianis ganviTarebis amocanebi
zrdasrulobis periodis mTavari amocanebis gansazRvrisas
mecnierebi xSirad mimarTaven eriksonis Teorias. mis mier gamoyofili
stadiebi aris safuZveli am asakis adamianebis ganviTarebis gasagebad.
eriksonis azriT, mTavari problema, romelic unda gadaiWras adreuli
zrdasrulobis asakSi, aris identobis miRwevasa da rolebis aRrevas
Soris da siaxlove _ izolacias Soris arsebuli konfliqtebi.
identobis miRweva aris centraluri problema Wabukobis asakSic.
miuxedavad amisa bevri mkvlevari (maT Soris eriksonic) Tvlis, rom
identobis sakiTxebi rCeba aqtualurad mTeli zrdasrulobis manZilze.
identobis miRwevis procesebi uzrunvelyofen uwyvetobis gancdas.
identobis ZiebaSi adamianebs uxdebaT sakuTari Tavis, prioritetebis da
socialur samyaroSi Tavisi adgilis Sefaseba da gadafaseba.
winaaRmdegoba siaxlovesa da izolacias Soris aseve
damaxasiaTebeli problemaa adreul mowifulobaSi. siaxlove moiTxovs
urTierTobebis damyarebas sxva adamianTan. siaxlove aris erTianoba ori
adamianis identobis, rodesac ar ikargeba TiToeulis ganumeorebeli
Tavisebureba. izolacia ki dgeba maSin, roca adamiani ver axerxebs aseTi
urTierTobis damyarebas. zogjer imis gamoc, rom individis identoba
imdenad sustia, rom sxvasTan erTianobisas Cndeba sakuTari Tavis
dakargvis riski.
erTi SexedviT, eriksonis Teoria stadiebs mkveTrad gamoyofs,
magram TviTon eriksoni sakmaod moqnilad iyenebs Tavis Teorias.
SeiZleba iTqvas, rom es aris cxovrebis normatiuli krizisebis modeli.
• varaudoben, rom identobis miRwevis da siaxlove-izolaciis
problemebi mTeli cxovrebis manZilze arsebobs. mniSvnelovanma
movlenebma, rogoricaa ojaxis wevris sikvdili, SeiZleba
erTdroulad gamoiwvios identobis da siaxlovis krizisi, radgan
adamiani danakargzec wuxs da cdilobs isev ipovos sakuTari Tavi
partnioris dakargvis Semdeg. sxva qalaqSi gadasaxleba, axali
samsaxuri _ aseTi movlenebi moiTxoven fsiqologiur da socialur
adaptacias. axal situaciaSi adamians SeiZleba dasWirdes ndobis
aRdgena, damoukideblobis miRweva, axali megobrebis SeZena da
sakuTari kompetenturobis da Sromismoyvareobis damtkiceba, manamde,
sanam marTlac SesZlebs xelaxla igrZnos Tavi zrdasrulad. e.i.
Tavidan gavla im safexurebis, romelic eriksons aqvs gamoyofili. ra
Tqma unda, am axalma situaciam SeiZleba misgan moiTxovos sakuTari
identobis axal konteqstSi gadaazreba. amitom bevri Tanamedrove
moazrovnisTvis identobis miRwevis procesebi da siaxlovis damyareba
aris centraluri mowifulobaSi ganviTarebis Taviseburebebis
gasagebad.
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• mniSvnelovania kulturuli konteqstis gaTvaliswineba, radgan
sxvadasxva kulturebSi SesaZlebelia mniSvnelovani koreqtivebi
Sevides am modelSi.
1938 wels harvardis universitetis 268 studentma (maT Soris iyo
jon f. kenedic) Tanxmoba ganacxada vailantis mier wamowyebul
longitudur kvlevaSi monawileobaze. SerCeuli iqna is studentebi,
romelTac janmrTelobis mdgomareoba, Tavdajerebuloba, miRwevis
moTxovnileba da xasiaTis simtkice sxvebTan SedarebiT maRali hqondaT.
wlebis manZilze isini gadioden testirebas, maTgan iRebden intervius,
aanalizebden monacemebs, akvirdeboden maT ganviTarebas. am kvlevas
uwodes "Grand study".
xdeboda monawileTa zrdasrulobaSi miRweuli warmatebebis
Sedareba studentobis wlebSi miRebul monacemebTan. 75 weli
dakvirvebebis Sedegad aRmoCnda, rom komunikabeluri, idealisti
studentebi, iseve warmatebuli iyvnen, rogorc morcxvi, Caketili
axalgazrdebi. mecnierebma daaskvnes, rom megobruloba mxolod Wabukobis
damaxasiaTebeli Tvisebaa, romelic araa aucilebeli gamovlindes
zrdasrul cxovrebaSic. momavalSi warmatebebis winaswarmetyveleba
ufro naTlad aris SesaZlebeli axalgazrdebis iseTi TvisebebiT,
rogoricaa praqtikuloba, pirovnebis organizebuloba da mTlianoba. 2013
wels dasrulda es kvleva. harvardis mecnierebi Seiswavliden ra
faqtorebi axdens gavlenas cxovrebiT kmayofilebis gancdis donesa da
bednierebis grZnobaze. aRmoCnda, rom yvelaze didi mteri mamakacebis
bednierebis aris alkoholi
kvlevam gamoavlina aseve, rom iseTi qcevebi da dacviTi meqanizmebi,
rogoricaa gandevna (cnobieridan gadatana aracnobierSi), proeqcia (sxva
adamianze gadatana) da sublimacia (sxva saqmianobaze, sxva sferoSi
gadatana), aris gadamwyveti zrdasrulobaSi warmatebis misaRwevad. es
meqanizmebi ganixileboda ara rogorc paTologiuri procesebi (rogorc
froidis TeoriaSia warmodgenili), aramed rogorc Sedegiani,
adaptaciuri reagireba krizissa da problemaze.
vailentis kvlevis Tanaxmad, es dacviTi meqanizmebi asruleben 5
mniSvnelovan funqcias zrdasruli adamianis cxovrebaSi:
1. isini akaveben emociebs dasaSveb farglebSi Zlieri emociuri
daZabulobis dros, magaliTad, sayvareli adamianis dakargvisas;
2. SeuZliaT biologiuri ltolvebis mimarTva saWiro mimarTulebiT;
3. saSualebas iZlevian moxdes koreqcia me-s xatis iseTi mniSvnelovani
cxovrebiseuli movlenebis kvaldakval, rogoricaa samsaxureobrivi
dawinaureba an mZime qirurgiuli operacia;

8
4. exmarebian adamians uaxloes garemocvaSi arsebuli konfliqtebis
mogvarebaSi;
5. uzrunvelyofen sindisTan seriozuli konfliqtebis racionalizaciis
SesaZleblobas. magaliTad, ramdenad dasaSvebia omis dros adamianis
mkvleloba.
kvlevis monawileebi yvelaze warmatebulad adaptacias axerxebden
sublimaciis meSveobiT. sublimaciisas adamiani miuRebel impulsebs
mimarTavs socialurad misaRebi miznebisken, imis magivrad rom gandevnos
es survilebi da impulsebi an moaxdinos maTi proecireba sxva adamianze.
yvela es meqanizmi, garkveuli TvalsazrisiT, xels uwyobs araxelsayrel
viTarebaSi me-s SenarCunebas da mis ganmtkicebasac ki.
ra faqtorebi uwyobs xels am dacviTi meqanizmebis ganviTarebas?
aRmoCnda, rom inteleqti da uzrunvelyofili bavSvoba ar iZleva
zrdasrulobaSi adaptirebulobis garantias.
vailentis kvlevam daadastura eriksonis stadiebis arseboba, magram
monacemebma ubiZga Seetana ori cvlileba am TeoriaSi. vailentma
gamoTqva varaudi, rom siaxlovis damyarebasa da generatiulobis
ganviTarebas Soris aris SedarebiT Sinagani simSvidis periodi da mas
uwoda karieris ganmtkicebis stadia, radgan individi koncentrirdeba
swavlaze, profesiuli statusis ganmtkicebaze, ojaxis uzrunvelyofaze.
rogorc ki misi kariera aewyoba, mas SeuZlia daubrundes identobis,
kerZod ki generatiulobis, sakiTxebs.
vailentma kidev erTi stadia Semoitana eriksonis generatiulobisa
da ego-s mTlianobis stadiebs Soris. am Sualedur stadiaze xdeba
konfliqti "cxovrebis azris SenarCunebasa" da "mouqnelobas" Soris.
Sinagani meryeoba da aRiareba sociokulturuli Rirebulebebis, maTi
rolis da im xerxebis, romlebiTac es Rirebulebebi unda iqnas
SenarCunebuli cxovrebis bolomde, TandaTan neldeba. adamiani ufro
Semwynarebeli xdeba, rac ego-s mTlianobisTvisaa damaxasiaTebeli, Tumca
jer ar miuRwevia misTvis.

ojaxuri erTierTobebisa da profesiuli ganviTarebis ciklebi

zrdasrulobis kriteriumi aris individis axal pirobebTan
warmatebiT Seguebisa da cvlilebebze reagirebis unari.
winaaRmdegobebisa da siZneleebis pozitiuri gadawyveta aris zrdasruli
adamianis qcevis safuZveli. zrdasruli adamianebis ganviTarebis gzaze
gvxvdeba kulturiT ganpirobebuli socialuri orientirebi, aseve
socialuri rolebi da socialuri ganwyobebi, romlebic Sedis ojaxuri
cxovrebisa da karieris ciklebSi. socialuri da emociuri ganviTarebis,
codnis, Cvevebisa da gamocdilebis zrdasTan erTad TandaTanobiT
SeimCneva fizikuri cvlilebebic, romelic am wlebSi xdeba. yvelafer

9
amaze SeiZleba gavlena iqonios moulodnelma matravmirebelma
movlenebma romlebic xdeba rogorc pirad cxovrebaSi, aseve
sazogadoebis da mTeli kacobriobis cxovrebaSi.
es SeiZleba iyos normatiuli da aranormatiuli movlenebi.
normatiulia movlenebi, romelTa dadgoma mosalodnelia garkveul dros
an ganicdeba amaTuim kohortis (Taobis) warmomadgenelTa umravlesobis
mier. aseTia, magaliTad, pirvelad samuSaos Zieba an Svilebis daojaxeba
da saxlidan wasvla. amis sapirispirod arsebobs aranormatiuli da
Zalian piraduli movlenebi, romlebic xdeba sruliad moulodnelad
individis cxovrebaSi: meuRlis uecari sikvdili, mZime avadmyofoba,
latariaSi mogeba an samsaxuris dakargva. aseTi movlenebi, Cveulebriv,
moulodnelad xdeba da ar Seexeba adamianebis farTo wres, isini
uSualod individSi iwveven mniSvnelovan daZabulobas da xSirad
adamianisgan cxovrebis Zirfesvian Secvlasac ki moiTxoven.

identoba, siaxlove da generatiuloba (adamiani ojaxSi da samsaxurSi).

eriksonis Tanaxmad, adreuli zrdasrulobis periodSi adamianis
yvelaze mniSvnelovani amocanaa Tavisi identobis dadgena. identobis
formireba _ uwyveti procesia. mowifulobaSi Sesulma individma unda
moaxdinos struqturireba da gadastruqtureba Tavisi piradi,
profesiuli da ojaxuri identobis Tavisi Sinagani da gare samyaros
cvlilebebTan erTad.
identobis formirebasTan mWidrod aris dakavSirebuli megobrebTan
da meuRlesTan siaxlovis ganviTareba. isini, visac ar aqvs am periodSi
axlo urTierTobebis Camoyalibebis unari, SeiZleba ganicdiden
sirTuleebs socialur adaptaciaSi (itanjeboden martoobis gancdiT,
daTrgunulobiT da eWvianobiT "podozritelnost").
eriksoni Tvlida, rom zrdasrulobaSi mTavaria generatiulobis
miRweva. bevri cdilobs generatiulobis miRwevas ojaxis SeqmniT da
STamomavlobaze zrunviT. sxvebi cdiloben amas profesiuli saqmianobiT.
maswavlebeli _ axali Taobis aRzrdiT, eqimi _ sicocxlis gadarCeniT,
muSa _ raRacis SeqmniT. mokled, individi ganixilavs sakuTar Tavs imis
mixedviT ra gaakeTa.
adamiani _ ojaxis wevri. sxvadasxva asakis qalebisa da mamakacebis
gamokiTxvam aCvena, rom ojaxi Zalian mniSvnelovania identobis
gancdisTvis. respodentebi saubrobden iseT socialur rolebze
rogoricaa mSoblis, meuRlis, dis an Zmis, Svilis roli. saubrobden
ojaxur siaxloveze, miznebsa da amocanebze, movaleobebze,
urTierTobebze, urTierTdaxmarebaze da TviTrealizaciaze. ojaxi aqvs
axalgazrdasac, romelic ar aris jer daojaxebuli, magram aris
gardamaval periodSi mSoblebis ojaxidan damoukideblobisken.

10
 adamiani _ mosamsaxure. rodesac mecnierebi cdilobden gaegoT riT
aris mniSvnelovani maTTvis samsaxuri, miiRes ZiriTadad ori tipis
pasuxi: gamoikveTa samuSaos Sinagani faqtorebi (interesi, profesiuli
kompetenturoba da sxv.) da garegani faqtorebi (xelfasi, statusi,
komfortuli samuSao adgili da samuSao dro, xelmZRvanelebis
kompetenturoba, kargi urTierTobebi kolegebTan, winsvlis SesaZlebloba
da sxv.).

თემა 2. მოწიფულობის ადრეული ხანა

fizikuri ganviTareba da janmrTeloba adreuli mowifulobis xanaSi

fizikurma ganviTarebam SeiZleba piks miaRwios adreuli
mowifulobis stadiaze.
fizikuri Zala da gamZleoba. qalebisa da mamakacebis umravlesoba
am asakSi arian energiulebi, Zlierebi da gamZle ise, rogorc arasodes.
fizikuri Zala, organoTa funqcionireba, reaqciis siswrafe, motoruli
Cvevebi da adamianis sxva fizikuri SesaZleblobebi aRwevs maqsimums 25 _
30 wlis diapazonSi. 30 wlidan ki isini nela, magram SesamCnevad
klebisken midis. Tumca Dam parametrebis daqveiTeba 30-dan 50 wlamde araa
iseTi mkveTri, rogorc bevrs warmoudgenia. 40 wlamde fizikuri
SesaZleblobebis done rCeba gasakvirad maRal doneze. mniSvnelovani
daqveiTeba am maxasiaTeblebis dgeba 40 wlis Semdeg. faqtiurad,
SesamCnevi daqveiTeba 25 wlis Semdeg SeiZleba iyos mxolod maRali
rangis spotsmenebisaTvis, sxvebisTvis ki es umniSvneloa.
am asakSi, Cveulebriv, fizikuri SesaZleblobebis daqveiTeba
SesamCnevi xdeba mxolod kritikul situaciebSi da maSin, roca mkveTrad
izrdeba datvirTva organizmze. magaliTad, orsuloba qalebTan, romelTa
asakic uaxlovdeba 40-s, meti energetikuli rezervebis xarjvas iTxovs da
mSobiarobis Semdegac meti dro sWirdebaT Zalebis aRsadgenad.
analogiurad, 25 wlis mamakacs ufro SeuZlia "gauZlos" ramdenime
samsaxuris datvirTvas, vidre 40 wlians.
fizikuri forma da janmrTeloba. es periodi janmrTelobis xanaa.
gansakuTrebiT es damaxasiaTebelia maTTvis, vinc yuradRebas aqcevs
kvebas, varjiSobs, ar eweva, ar moixmars narkotiks da zedmet alkohols.
janmrTelobisadmi yuradReba da fizikuri varjiSis Cvevebi, romelic am
asakSi yalibdeba, xSirad SenarCundeba mTeli cxovrebis manZilze.
fizikuri forma. varjiSi da swori kveba Zlier gavlenas axdenen
zrdasrulTa fizikur formaze. rac ukeTesia kveba da fizikuri
momzadeba mowifulobis xanaSi, miT ufro gvian modis sibere.
sikvdilianoba adreul zrdasrulobaSi, sxva periodebTan
SedarebiT, dabalia. ganviTarebul qveynebSi axla qalebi iSviaTad
11
iRupebian mSobiarobisas, tuberkuliozic aRar aris ZiriTadi saSiSroeba
am asakisTvis. xolo diabets, gulisa da Tirkmelebis daavadebebs
medicina axla ufro ukeT ereva. aSS-Si ZiriTadi mizezi 25-44 ww
mamakacebis sikvdilis aris aiv-infeqcia, romelsac mivyavarT Sidsamde;
Savkaniani mamakacebisTvis sikvdilis meore gavrcelebuli mizezia
kanondarRvevebisas srolaSi daRupva; mesame mizezia avtosagzao
SemTxvevebi.
avadmyofoba, Sromisuunaroba da fizikuri nakli. marTalia,
sikvdilianoba dabalia sxva asakobriv jgufebTan SedarebiT, magram
pirveli niSnebi daavadebebis swored am periodSi Cndeba. SeiZleba ver
vgrZnobT veranair simptomebs, magram iwyebs ganviTarebas filtvebis,
gulis da Tirkmelebis daavadebebi, arTritebi da arTrozebi,
aTerosklerozi da RviZlis cerozi. garda amisa, am periodSi iwyeba
iseTi genetikuri daavadebebi, rogorc diabeti da anemia an gafantuli
sklerozi da revmatoiduli arTriti, aseve stresebTan dakavSirebuli
hopertonia, kuWis wyluli da depresia.
zogjer socio-kulturuli movlenebi da faqtorebi qmnian
situaciebs, romelic iwvevs axalgazrdebSi daavadebebs da sikvdilsac
ki. magaliTad, omis dros bevri iRupeba an invalidi xdeba, aseve
damnaSaveobis maRali donis gamo did qalaqebSi aris msxverpli da
narkomania;
fizikur naklTan Segueba Znelia nebismier asakSi, magram
gansakuTrebiT Wabukobis xanaSi da adreul zrdasrulobaSi, rodesac
xdeba profesiis arCeva da intimuri urTierTobebis damyareba.
aris 3 faqtori, romelic gavlenas axdens fizikuri naklis mqone
adamianis garemosadmi adaptirebulobaze:
1. mniSvnelovania adamianma icodes da esmodes raSi mdgomareobs
misi fizikuri defeqti da amiT gamowveuli SezRudvebi (Tu ver swavlob
iaponurs, am enis SemswavlelTa jgufSi siZneleebi geqneba);
2. ramdenad xerxdeba gamklaveba sxva adamianebis ganwyobebTan da
socialur molodinebTan. invalidebi xSirad Seejaxebian xolme
stereotipul azrovnebas da diskriminaciasac ki _ isini ecodebaT, an
amcireben, uunarod Tvlian;
3. mniSvnelovania gamklaveba SiSebTan, auxdenel ocnebebTan,
frustraciasTan, dakargul SesaZleblobebTan, aseve danaSaulis
grZnobasTan da risxvasTan.
aseTi krizisis sawyis etapze dainvalidebuli adamiani SeiZleba
ganicdides mwuxarebas, SeiZleba iyos Tavzardacemuli da dakargos
imedi; is, rom ver akeTebs yoveldRiurobaSi imas, rac sxvebisTvis
problema ar aris (magaliTad, damoukideblad Cacma an Tavis movla),
SeiZleba iwvevdes gaRizianebas da imedgacruebas. risxva da frustracia

12
(imedgacrueba) Cndeba sazogadoebis mxridan moulodnelad Seqmnili
dabrkolebebisa da barierebis gamoc (magaliTad, transportis
araTavsebadoba invalidebis etlebisadmi an trotuarebisa da kibeze
asasvlelebis ar arseboba).

kognituri ganviTareba _ formaluri operaciebis miRma.

bavSvobisa da mozardobis periodSi kognituri ganviTarebis
stadiebi SedarebiT naTlad gamoiyofa, rac arc ise advilia
zrdasrulobis periodSi. dgeba kiTxva _ ra xdeba am periodSi _
grZeldeba kognituri zrda Tu ara?
uwyveti inteleqtualuri aqtivobis Sedegad adamianebi droTa
ganmavlobaSi (mowiful asakSi an xandazmulobaSi) floben ufro met
codnas. magram es cvlilebebi TviTon inteleqtSi xdeba Tu mxolod
adamianis kompetencia icvleba? kognituri ganviTareba Wabukobis Semdegac
grZeldeba? erTmniSvnelovani pasuxi araa. adre mecnierebi Tvliden, rom
inteleqtualuri unarebi piks aRweven Wabukobis xanis bolos da
adreuli mowifulobis dasawyisSi. magaliTad, rodesac pirveli msoflio
omis dros yvela wvevamdels Cautares zogadi inteleqtis testebi,
aRmoCnda, rom 15-dan 25 wlamde axalgazrdebi ukeT asrulebden testebs,
vidre SedarebiT ufrosi asakis wvevamdelebi. 30-ian da 40-ian wlebSi
Catarebulma kvlevebmac igive aCvenes. ufrosi Taobis Sedegebi yovelTvis
iyo ufro dabali, vidre axalgazrda Taobis. magram aseTi Sedegebi
miiReboda yovelTvis kveTis meTodiT kvlevisas.
40-iani wlebis bolos, longituduri kvlevis monacemebis Tanaxmad,
sapirispiro Sedegebi miiRes. cdispirTa monacemebi izrdeboda, yovel
SemTxvevaSi 20-dan 40 wlamde periodSi da stabilur doneze rCeboda
(plato) 45 wlis asakidan. riT aixsneba aseTi sxvaoba monacemebSi? mizezi
SeiZleba iyos sxvadasxva, magram sxva faqtorebTan SedarebiT gamoikveTa
ganaTlebis nakleboba ufros TaobaSi.
romeli kognituri unarebi izrdeba asakTan erTad? davalebebis
swrafad Sesrulebis unari, meqanikuri mexsiereba da matricebiT
operirebis unari piks aRwevs Wabukobis bolos. profesia xSirad
ganapirobebs Tu romeli unari ganviTardeba TandaTan. magaliTad,
fsiqologebs uviTardebaT albaTuri azrovneba, humanitarebs _
tradiciuli logika. Tanac, xSirad gamoyenebuli Cvevebi ufro didxans
SenarCundeba. magaliTad, arqiteqtorebi inarCuneben sivrcul-vizualur
azrovnebas saSualoze maRal doneze. msjelobisa da daskvnis unari
mTeli cxovrebis manZilze viTardeba. marTalia bevri mecnieri Tvlis,
rom ganaTleba da gamocdileba gavlenas axdens am procesze, magram
saerTo azri jer ar aris sabolood SeTanxmebuli.

13
 studenturi azrovnebis "stadiebi". arsebobs Tu ara formaluri
operaciebis stadiis Semdgomi stadia? aris Tu ara Tvisebrivi sxvaoba
axalgazrdebis azrovnebasa da mozrdili adamianis azrovnebas Soris?
arsebobs perris klasikuri kvleva. harvardisa da redklifis
universitetebis 140 studentisgan 4 wlis ganmavlobaSi yoveli saswavlo
wlis bolos iRebden intervius. mkvlevarebs ainteresebdaT rogor
gaiazrebden studentebi Tavisi swavlis gamocdilebas. gansakuTrebiT
ainteresebdaT rogor axerxebden studentebi gaerkviaT arsi im uamravi
urTierTsapirispiro mosazrebebis da kriteriumebis, romelsac xvdeboden
swavlisas. perrim gamoyo "studenturi azrovnebis" stadiebi:
1. Tavidan studentebi axdenden samyaros interpretirebas da Tavis
gamocdilebas ganixilavden dualisturad. isini eZebden WeSmaritebas
da miiswrafoden codnisken. samyaro SeiZleboda yofiliyo mxolod
kargi an cudi, swori an araswori. maswavleblebis rolia _ aswavlon
studentebs, studentebis roli ki _ bejiTad iswavlon.
2. magram male es studentebi Seejaxnen gansxvavebebs Tvalsazrisebs
Soris, meryeobas da Secdomebs. SesaZlebelia sagnebi iswavleboda ise,
rom aeZulebinaT studentebi damoukideblad moeZebnaT pasuxebi
kiTxvebze. SesaZloa profesorebs TviTon ar hqondaT swori pasuxebi
am kiTxvebze.
3. gansxvavebul TvalsazrisebTan Sejaxebis Semdeg studentebma
TandaTanobiT daiwyes aRiareba am mravalferovnebis da moswondaT
kidec. maT daiwyes miCveva azrTan, rom adamianebs aqvT gansxvavebuli
mosazrebebis qonis ufleba da gaiges, rom nebismier adamians SeuZlia
konteqstidan gamomdinare, erTsa da imave movlenas miudges ori
mxridan.
4. Tumca aseTma midgomam adgili dauTmo sabolood moTxovnilebas
sadao sakiTxebze mivides sakuTar mosazrebamde da pasuxebamde.
studentebi Tavidan sifrTxiliT, Semdgom ki myarad iRebden
pasuxismgeblobas Tavis arCevanze.
amrigad, studentebi TandaTan ufro Semwynarebeli iyvnen mravali
gansxvavebuli mosazrebebisadmi da Semdgom pasuxismgeblobas iRebden
damoukideblad arCeul poziciasa da gakeTebul arCevanze.
klaus rigelma adreul mozrdilobaSi kognituri ganviTarebis
mniSvnelovan miRwevad miiCnia winaaRmdegobebis gagebis unari. is amas
uwodebs dialeqtikur azrovnebas _ adamiani gaiazrebs sapirispiro
mosazrebebs da akeTebs am mosazrebebis sinTezirebas an integrirebas.
dialeqtikur azrovnebaSi gansakuTrebiT mniSvnelovani aspeqtia
idealurisa da realuris integracia.
perrisa da rigelis mosazrebebi emyareba universitetis
studentebis gamokvlevas, amitom SesaZloa Sedegebi studentobis

14
Taviseburebas asaxavs da ara zogadad zrdasrulobisaTvis
damaxasiaTebel cvlilebas.

zrdasruli adamianis inteleqtis stadiebi (Saie);

k. uorner Saiesa TeoriaSi yuradReba gamaxvilda imaze, Tu rogor
iyeneben zrdasruli adamianebi inteleqts cxovrebiseuli
moTxovnilebebis dasakmayofileblad.
Saies zrdasruli inteleqtis ganviTarebis stadiebi. yvela mecnieri
ar iziarebs ideas, rom arsebobs inteleqtis ganviTarebis mexuTe stadia.
zogierTi Tvlis, rom zrdasrulis azrovnebis ganmasxvavebeli niSania
moqniloba, romliTac zrdasrulebs SeuZliaT gamoiyenon yvela is
kognituri unari, romelTac floben am momentisTvis. Saie Tvlis, rom:
• formaluri operaciebis stadiaze adamians ukve aqvs azrovnebis
Zlieri instrumentebi da amas SeZenis periods uwodebs.
• adreul zrdasrulobaSi Cven viyenebT Cvens inteleqtualur unarebs
rom gavikeToT kariera da avirCioT cxovrebis stili. da am periods
miRwevebis periods uwodebs. es mniSvnelovani periodia adamianis
kognitur ganviTarebaSi, rodesac Cven viyenebT cxovrebaSi azrovnebis,
problemebis gadawyvetisa da gadawyvetilebis miRebis unarebs. magram
saubaria ara inteleqtualur testebze an abstraqtul problemebze.
ZiriTadad igulisxmeba, rom zrdasrulma adamianma unda miiRos piradi
gadawyvetilebebi cxovrebis Sesaxeb.
• isini, vinc warmatebiT arTmevs Tavs amas, iZenen pirovnul
damoukideblobas garkveuli xarisxiT da gadadian kognituri Cvevebis
moqnilad gamoyenebis Semdgom fazaze. es aris socialuri
movaleobebis periodi. Saies azriT, saSualo zrdasrulobaSi Cven
viyenebT Cvens kognitur unarebs, rom gadavwyvitoT sxvebis problemebi
_ ojaxSi, TemSi, samsaxurSi. zogs sakmaod rTuli movaleobebi aqvs da
SeuZlia gamoiyenos Tavisi unarebi administraciuli funqciebis
Sesasrulebladac.
• dabolos, ufro gvian asakSi gadasawyveti problemebis xasiaTi isev
icvleba. mTavari amocana xdeba mTeli ganvlili cxovrebis movlenaTa
reintegracia _ sakuTari cxovrebis mTlianobaSi gaazreba da
ganvlili gzis Sefaseba.
rogorc Cans, SaiesTvis kognituri ganviTarebis arsi
zrdasrulobis xanaSi mdgomareobs ara unarebis gafarTovebasa da
struqturul cvlilebebSi, aramed ramdenad moqnilad iyenebs inteleqts
adamiani cxovrebis sxvadaxva periodSi.

kognituri ganviTareba da me-s formireba (lovingeri)

15
 bevri mecnieri cdilobda gaeerTianebia kognituri da pirovnebis
ganviTarebis aspeqtebi. jein lovingeri cdilobda aRewera sakuTar Tavze
warmodgenebis formirebis procesi da daedgina SeiZleba Tu ara droTa
ganmavlobaSi me-koncefciebis ganviTareba warmodgenil iqnas
Tanamimdevari stadiebis saxiT. lovingerma SeaerTa fsiqoanalizis
Teoria, kolbergis moraluri ganviTarebis zogierTi aspeqti da
empiriuli kvlevebis Sedegebi. misi modelis birTvi aris ego _
fsiqoanalituri konstruqti, romelic axloa me-koncefciasTan, magram
misi identuri ar aris. lovingeri Tvlis, rom individis ego gadis
ganviTarebis ramdenime stadias. es stadiebi gamoiyofa kognituri
unarebis, moraluri ganviTarebisa da pirovnuli faqtorebis
gaTvaliswinebiT.
Tavisi mosazrebebis Sesamowmeblad lovingerma SeimuSava ramdenime
testi "daumTavrebeli winadadebebis". is varaudobda, rom adamianebi
winadadebebis damTavrebisas axdenen Tavisi Sexedulebebis proecirebas
pasuxebSi da ase SegviZlia gavigoT rogoria maTi damokidebuleba gare
samyaros mimarT. mravalricxovani testirebis Sedegad man gamoyo
pirovnebis ganviTarebis 7 ZiriTadi stadia da 3 gardamavali stadia.
yoveli momdevno stadia winamorbedze ufro rTulia da ganviTarebis
procesSi arcerTis gamotoveba ar xdeba. adamianTa mxolod umniSvnelo
raodenoba aRwevs damamTavrebel stadiebs. marTalia, stadiebi garkveuli
TvalsazrisiT dakavSirebulia qronologiur asakTan, magram aucilebeli
araa masze iyos damokidebuli.
pirveli stadia _ socialuramdeli da meore stadia _ impulsuri _
gvxvdeba yvelaze patara bavSvebTan. socialuramdel stadiaze patarebi
damokidebulebi arian im adamianebze, vinc maTze zrunavs,
koncentrirebuli arian mxolod sakuTar moTxovnilebebze da
miiswrafian siamovnebis miRebisken. isini afaseben Tavis qcevebs rogorc
kargs an cuds imis mixedviT amas dasja mohyveba Tu waxaliseba. maTi
warmodgenebi samyaroze egocentrulia da konkretuli. lovingerma
aRmoaCina, rom zogi bavSvi, mozardi da zrdasrulic ki ganviTarebisas
Cerdeba am stadiaze.
mesame _ TviTdacvis _ stadia ufro progresulia. am stadiaze
individis ego xelmZRvanelobs angarebiT da piradi interesebis
dasakmayofileblad yvela xerxi misaRebia misTvis. aseTi adamianebis
damokidebuleba sxvebisadmi mimarTulia kontrolze, batonobaze,
motyuebaze da sakuTar usiamovnebebze. isini emorCilebian wesebs mxolod
piradi sargeblis miRebisaTvis da usiamovnebis asacileblad. adreuli
bavSvobis asakSi bevria am stadiaze. aq CarCenili mozardebi da
zrdasrulebi, Cveulebriv, cdiloben yvelaferSi naxon piradi sargebeli
da aseve sxvebiT manipulirebas cdiloben.
16
 am wertilSi xdeba gadasvla meoTxe, konformistul, stadiaze,
romelsac adamianebis umravlesoba aRwevs an bavSvobis bolos, an
siymawvilis xanaSi. individis ego sakuTar Tavze msjelobs garegani
niSnebis mixedviT (qoneba, statusi, reputacia da garegnoba) da iSviaTad
mimarTavs Sinaganad gancdil grZnobebs da msjelobisas mxolod
banalurobas da kliSeebs iyenebs. wesebs emorCilebian ubralod "imitom,
rom es wesia" an "imitom rom asea saWiro". individi cdilobs aicilos
sxvebis mxridan gakicxva da roca amas ver axerxebs, aqvs sircxvilis
grZnoba.
Semdegi sami stadia saWiroebs refleqsiur azrovnebas mozardis an
zrdasrulisgan. mexuTe, gacnobierebis, stadiaze individebi aRmoaCenen,
rom "swori" da “araswori” damokidebulia imaze, ganixilaven Tu ara
Tavis Taviseburebebs, miRwevebsa da idealebs sakuTari principebidan
gamomdinare, aucileblad xelmZRvaneloben Tanatolebis an
avtoritetuli adamianebis normebiT. wina stadiebisgan gansxvavebiT, am
stadiaze adamianebs aqvT TviTkritikis unari.
sanam meeqvse, avtonomiurobis stadias miaRwevden, adamianebma unda
gaiaron gardamavali stadia, romelzec iZenen paradoqsuli
urTierTobebisadmi Semwynareblobis unars. ukeT acnobiereben Sinagan
konfliqtebs pirad saWiroebebsa da maTive idealebs Soris, aseve
sakuTari da sxva adamianebis mier erTidaigive movlenebis aRqmebSi. sul
ufro metad aqvT unari gaugon sxvas, gamoxaton Semwynarebeloba maTi
Sexedulebebis, arCevanis da gadawyvetilebebis mimarT. gansjis magivrad
isini iwyeben imis aRiarebas, rom sxvasac aqvs sakuTari gadawyvetilebis
miRebis ufleba.
meSvide, integraciuli stadia miiRweva rodesac adamianebi iZenen
unars pativi scen da Searigon konfliqturi mxareebi Tavis TavSic da
sxvebTan urTierTobebSic. isini aramarto moTminebiT iReben imas, rom
sxvebi maT ar gvanan, aramed afaseben kidec am gansxvavebas. lovingeris
mixedviT am stadias aRwevs zrdasrulebis 1%-ze naklebi.

17
Автор книги «Язык тела. Впечатляйте, убеждайте и добивайтесь успеха с помощью языка тела» Макс
Эггерт составил список из 75 признаков языка тела, которые, по словам писателя, помогут лучше
понимать собеседника. AdMe.ru уверен, если проявить немного усердия, то можно легко научиться
понимать невербальные сигналы.

fizikuri niSani ras SeiZleba gamoxatavdes

1. Xorxis moZraoba SfoTva, tyuili
2. Xelebi korpusis win, sayelos, CanTis, sakuTar TavSi daurwmunebloba
samkaulis da a.S. Sexeba
3.
4.
5.

18
 წყაროvikent

meTodika “daumTavrebeli winadadebebi”

1. vfiqrob, rom mamaCemi iSviaTad

2. Tu yvela Cemi winaaRmdegia
3. me yovelTvis mindoda
4. me rom xelmZRvaneli Tanamdeboba mekavos
5. momavali me meCveneba
6. Cemi ufrosebi (xelmZRvanelebi)
7. vici, rom suleluria, magram meSinia
8. vfiqrob, rom namdvili adamiani
9. roca bavSvi viyavi
10. qalis (mamakacis) ideali CemTvis aris
11. roca vxedav qals mamakacis gverdiT
12. sxva ojaxebis umravlesobasTan SedarebiT Cemi ojaxi
13. yvelaze ukeT me vmuSaob -------------------------- erTad
14. dedaCemi da me
15. yvelafers gavakeTebdi rom daviviwyo
16. mamaCems rom ndomeboda
17. vfiqrob sakmaod niWieri var, rom
18. Zalian bednieri viqnebodi, Tu
19. Tu vinme muSaobs Cemi xelmZRvanelobis qveS
20. imeds vamyareb
21. skolaSi Cemi maswavleblebi
22. Cemi amxanagebis umravlesobam ar icis, rom meSinia
23. ar miyvars adamianebi, romlebic
24. odesRac
25. vfiqrob, rom Wabukebis (qaliSvilebis) umravlesoba
26. colqmruli cxovreba me meCveneba
27. Cemi ojaxi meqceva rogorc
28. Adamianebi, visTanac vmuSaob
29. dedaCemi
30. Cemi yvelaze didi Secdoma iyo
31. minda, rom mamaCemi
32. Cemi yvelaze didi sisuste aris
33. Cemi faruli survili cxovrebaSi
34. Cemi xelqveiTebi
35. dadgeba is dRe, roca
19
 36. roca Cemi ufrosi miaxlovdeba
37. minda rom aRar meSinodes
38. yvelaze metad miyvars is adamianebi, romlebic
39. isev axalgazrda rom gavxde
40. vTvli, rom qalebis (mamakacebis) umravlesoba
41. me rom normaluri sqesobrivi cxovreba mqondes
42. CemTvis cnobili ojaxebis umravlesoba
43. Miyvars muSaoba adamianebTan, romlebic
44. vTvli, rom dedebis umravlesoba
45. roca axalgazrda viyavi, danaSauls vgrZnobdi, Tu
46. vfiqrob, rom mamaCemi
47. roca bedi ar mwyalobs, me
48. yvelaze metad cxovrebaSi minda
49. roca sxvebs vaZlev davalebebs
50. roca moxuci viqnebi
51. adamianebi, romelTa Cemze upiratesobasac vaRiareb
52. Cemma SiSebma (oposenia) araerTxel maiZules
53. roca me ar var, Cemi megobrebi
54. Cemi bavSvobis yvelaze cocxali mogoneba aris
55. Zalian ar momwons, roca qalebi (mamakacebi)
56. Cemi sqesobrivi cxovreba
57. roca bavSvi viyavi, Cemi ojaxi
58. adamianebi, romlebic CemTan erTad muSaoben
59. miyvars dedaCemi, magram
60. yvelaze cudi rac gamikeTebia, aris

gasaRebi

NN# damokidebuleba kiTxvebi

1 damokidebuleba mamisadmi 1 16 31 46

2 damokidebuleba sakuTari Tavisadmi 2 17 32 47

3 ararealizebuli SesaZleblobebi 3 18 33 48

4 damokidebuleba xelqveiTebisadmi 4 19 34 49

5 damokidebuleba momavlisadmi 5 20 35 50

6 damokidebuleba maRla mdgomi adamianebisadmi 6 21 36 51

7 SiSebi da SfoTvebi 7 22 37 52

8 damokidebuleba megobrebisadmi 8 23 38 53

9 damokidebuleba sakuTari warsulisadmi 9 24 39 54

10 damokidebuleba sapirispiro sqesis adamianebisadmi 10 25 40 55

20
11 seqsualuri damokidebulebebi 11 26 41 56

12 damokidebuleba ojaxisadmi 12 27 42 57

13 damokidebuleba TanamSromlebisadmi 13 28 43 58

14 damokidebuleba dedisadmi 14 29 44 59

15 danaSaulis grZnoba 15 30 45 60

21
თემა 3.

mowifuloba (adreuli xana):

ojaxis cikli (mSoblis roli, bavSvebis aRzrda, martoxela mSoblebi);

I. siaxlove (siyvaruli, partnioris arCeva, qorwineba, Tanacxovreba);

siyvaruli. sternbergma wamoayena siyvarulis samkomponentiani
Teoria. is Tvlis, rom siyvaruls sami Semadgeneli nawili aqvs.
1. intimuroba, siaxlovis gancda. Seyvarebuli adamianebi grZnoben
gansakuTrebul kavSirs erTmaneTTan. siaxlove sxvadasxvanairad SeiZleba
gamovlindes: Cven gvinda ukeTesi gavxadoT axlobeli adamianis cxovreba;
vgrZnobT aSkara simpaTias da bednieri varT maT gverdiT; imedi gvaqvs,
rom mxars dagviWeren rTul periodSi da vcdilobT vaCvenoT rom Cvenc
mzad varT aseTi saqcielisTvis; Cven saerTo interesebi gvaqvs, SeiZleba
saqmianobac; am adamians vuziarebT Cvens fiqrebs, grZnobebs, nivTebs.
faqtobrivad, saerTo interesebi da saqme SeiZleba gaxdes erT-erTi
gadamwyveti faqtori simpaTiidan colqmrul urTierTobebze
gadasvlisTvis.
2. vneba aris agznebis iseTi saxe, romelic iwvevs fizikur
ltolvas da seqsualur qcevas. sqesobrivi moTxovnilebebi aq
mniSvnelovania, magram ara erTaderTi mamoZravebeli. mniSvnelovania
sakuTari Tavis pativiscemis moTxovnileba, mikuTvnebis moTxovnileba da
moTxovnileba miiRo daxmareba mZime wuTebSi. zogjer siaxlove iwvevs
vnebas, zogjer ki _ piriqiT xdeba. aris SemTxvevebi, roca vnebas ar
axlavs siaxlove da siaxloves _ vneba.
3. gadawyvetileba/movaleobebi. mas aqvs xanmokle da xangrZlivi
aspeqtebi. xanmokle aspeqti imaSi aisaxeba, rom konkretul adamians
uyvars meore adamiani. xangrZlivi aspeqti ki aris valdebuleba
SeinarCuno es siyvaruli. adamianTa umravlesobas imedi aqvs, rom
idealur siyvaruls Sexvda, magram xSirad col-qmrul urTierTobebSi
vneba kvdeba da mis adgils ikavebs siyvaruli-megobroba.
siaxlove SeiZleba daingres uaryofiTi grZnobebiT. gansakuTrebiT
damangrevelia risxva/brazi da gaRizianeba. siaxloves xels uSlis aseve
SiSi, rom Senze uars ityvian.

siyvarulis saxeebis sistema sternbergis samkomponentiani Teoriis

mixedviT
siyvarulis saxe intimuroba vneba movaleoba

22
simpaTia + - -

vnebiani siyvaruli - + -

mogonili siyvaruli - - +

romantiuli siyvaruli + + -

siyvaruli-megobroba + - +

brma siyvaruli - + +

idealuri siyvaruli + + +

partnioris arCeva. rogor irCeven adamianebi partniors/meuRles?

arsebobs sxvadaxva Teoria, romelTa avtorebic cdiloben amis garkvevas.
froidis fsiqoanalitikuri Teoriis Tanaxmad, bavSvs aqvs unari
sapirispiro sqesis mSoblis mimarT ltolva gadaitanos sxva
socialurad misaReb obieqtebze da/an adamianze. partnioris arCevasac es
ganapirobebs.
uinCis komplementaruli moTxovnilebebis Teoria (1958) emyareba
princips, rom sapirispiro Tvisebebis mqone adamianebi erTmaneTs izidaven.
magaliTad, Zalauflebis moyvarul mamakaci SeiZleba miizidos
mokrZalebulma qalma, xolo wynari da rbili mamakacisTvis mimzidvelia
energiuli qali.
sentersis meuRlis instrumentaluri SerCevis Teoria (1975) aseve
umniSvnelovanesad Tvlis moTxovnilebebis dakmayofilebas, magram
aRniSnavs, rom zogi moTxovnileba (magaliTad, sqesobrivi da mikuTvnebis)
ufro mniSvnelovania, vidre sxvebi _ adamians izidavs is, visac misi
msgavsi an Semavsebeli moTxovnilebebi aqvs. sandersis azriT, zogierTi
moTxovnileba ufro damaxasiaTebelia mamakacebisTvis, vidre qalebisTvis
da piriqiT.
marSteinis "stimuli-faseuloba-roli" Teoriis (1982) Tanaxmad, qali
da mamakaci urTierTobis ganviTarebisas ecnobian partnioris Rirsebebs
da naklovan mxareebs ფლირტის sam stadiaze. stimulis stadiaze, rodesac
qali da mamakaci pirvelad xvdebian erTmaneTs, yalibdeba sawyisi
warmodgena partnioris garegnobaze, mis gonierebaze da sazogadoebaSi
moqcevis unarze. Tu pirveli STabeWdileba dadebiTia, wyvili gadadis
urTierTobaTa meore stadiaze, romelsac hqvia Rirebulebebis Sedarebis
stadia. erTmaneTTan saubrebidan maT unda gaigon SeTavsebadia Tu ara
maTi interesebi, ganwyobebi, Sexedulebebi da moTxovnilebebi. Tu
Sefaseba isev dadebiTia, gadadian bolo stadiaze _ partniorebi adgenen

23
ramdenad Tavsebadi arian Tavisi rolebis Sesrulebisas qorwinebaSi an
sxva tipis urTierTobebSi.
qorwineba. kulturuli sxvaobebi, tradiciebi, rwmena did rols
asrulebs. qorwinebis ritualebi da tradiciebi gansxvavebulia
ganviTarebul qveynebSi da magaliTad, arabul an aziur qveynebSi. aseve
icvleba istoriulad da socialuri statusis mixedviT. CvenTan rogoria
mdgomareoba?
Tanacxovreba _ erTad cxovreba qorwinebis gareSe. ramdenad
misaRebia Cveni kulturisTvis? SeimCneva Tu ara raime cvlileba bolo
wlebSi an TaobebSi? erTnairi mdgomareobaa soflad da qalaqSi? _ es
yvelaferi sakvlevia.
martoxela adamianebi. bevr istoriul periodSi martoxeloba
ganixileboda rogorc raime ubedurebis an omis samwuxaro Sedegi, an
martoxelebi iTvleboden umwifar da arasrulfasovan adamianebad.
zogierT daqorwinebulebs axlac aqvT stereotipuli warmodgenebi
martoxelebze. isini TiTqos arian sicocxlis moyvarulebi (cxovroben
mxiarulad, arafers ar ikleben) an piriqiT, warumatebeli adamianebi
(fizikurad ar arian momxiblavi, socialuri cxovreba ar aqvT an Tu aqvT
_ Raribi. SeiZleba surT kidec ojaxis Seqmna, magram ar aqvT
partnioris moZebnis unari, an imdenad umwifarebi arian, rom ar
SeuZliaT mSoblebisgan damoukideblad cxovreba da sxv.).
istoriulad adamianTa didi jgufebi periodulad rCeboden marto
_ “Sinaberebad” an “berbiWebad”. magaliTad, aSS-Si martoxelebi bevri iyo
didi depresiis, meore msoflio omis dros. 50-ian wlebSi ki piriqiT,
qorwinebis gareSe saqorwino asakis adamianTa mxolod 4% iyo darCenili.
aseve am periodSi Zalian daiwia qorwinebis asakma. 70-ian da 80-ian wlebSi
isev daiwia 25 wlamde asakSi qorwinebis donem (depresiis wlebis
maCvenebelze qveviT daiwia).
amerikul kulturaSi moxda mniSvnelovani cvlilebebi martoxela
adamianebis adgilTan dakavSirebiT. aramarto is, rom es aris yvelaze
swrafad mzardi populacia, aramed isic, rom adamianebis umravlesoba
zrdasruli cxovrebis did nawils atarebs marto da ara qorwinebaSi.
martoxeloba xdeba maxasiaTebeli damoukideblobis da ara sasircxvilo
ram, martoxeloba adamians aZlevs SesaZleblobas ganaviTaros
mravalmxrivi urTierTobebi. martoxeloba aRar aris mdgomareoba,
romelsac Secvli rogorc ki SesaZlebeli iqneba _ mas sakuTari
dadebiTi mxareebi aqvs. qorwineba aRar aris WiSkari, romelic
zrdasrulobaSi gadagiyvans. adamianTa umravlesobisTvis es aris ufro
sasurveli movlena, magram ukve aRar aris cxovrebis ZiriTadi kursi.
adamianebi moxaruli arian Tu Sexvdebian mTeli cxovrebis megzurs,
magram bevrad naklebad arian sasowarkveTili (imedgacruebuli) Tu es ar

24
moxdeba. sul ufro metad, adamianebs martoxeloba urCevniaT, vidre
aradamakmayofilebeli urTierTobebi.
gamokiTxvebi aCvenebs, rom mamakacebi ufro Tbilad arian
ganwyobili qorwinebis mimarT, qalebi ki sul ufro da ufro frTxilad
wonian finansur, emociur da profesiul poziciebs, romelic moaqvs
qorwinebas. radgan isini ufro acnobiereben, rom qalebi jer kidev
akeTeben met saqmes saxlSi da bavSvebis movlisas, da es ufro da ufro
ar moswonT.
daqorwinebuli wyvilebi dominanturi iyo aSS-Si qveynis
daarsebidan. XX saukunis 50-ian wlebSi ki ukve ojaxebis 80 procents
Seadgenden daqorwinebuli wyvilebi. 2006 wels daqorwinebuli wyvilebi
iyvnen mTlianad ojaxebis mxolod 50.7 procenti. rogorc Cans,
martoxela adamianebi xdebian axali umravlesoba. maSin roca bevri
aqtiurad eZebs meore naxevars, umetesoba dakavebulia savse cxovrebiT,
bavSvebis yolis CaTvliT. dauqorwinebeli amerikelebi Seadgenen samuSao
Zalis 40 procents, saxlis myidvelebis 40 procents, amomrCevelTa 35
procents.
arsebobs “kulturuli atitudebi martoxelebis mimarT”. e.kei
trimbergeri ikvlevda damokidebulebas martoxela qalebisadmi
sxvadasxva kulturaSi, ganskuTrebiT indoeTSi (avtoria wignisa “axali
martoxela qali”). man aRwera sami mTavari “kulturuli faqtori”,
romelic misi azriT, “aadvilebs martoxelobas indoeTSi”. pirveli,
martoxelobas ar aqvs negatiuri mniSvneloba rogorc es aris bevr
dasavlur qveyanaSi. dauqorwinebloba ganixileba pozitiurad. meore, is
ambobs, rom garigebiT qorwinebebi, dominanturia indoeTSi. Tu qali
gardaicvleba dauqorwinebeli, amis mizezi SeiZleba iyos: arasakmarisi
mziTevi misi ojaxis mxridan, kargi wyvilis povnis siZnele, da a.S. aSS-
Si ki jer kidev ganixilaven xanSiSesul martoxelebs, gansakuTrebiT
qalebs, eWviT, TiTqos raRac seriozuli pirovnuli xarvezi aqvT.
trimbergeris mesame fundamenturi faqtoria “kulturuli
imperativi”, rom daqorwineba aucilebelia bednierebisaTvis. rogorc
kultura, Cven gvaqvs fantastikurad ararealisturi molodinebi Cveni
urTierTobebis Sesaxeb, rogorc raRac zRaprulis (“da cxovrobden
bednierad sikvdilamde...”). trimbergeris azriT, qorwinebas indoeTSi
ufro maRali Rirebuleba aqvs. magram misi mizania ojaxuri kavSirebi da
ara wyvilis bedniereba. SeTavsebadoba wyvils Soris araa dakavSirebuli
sulieri megobris povnasTan, aramed es aris Seupovari Sroma ojaxis
daxmarebiT. rogorc Sedegi, martoxela qali indoeTSi ar aris sacodavi
imis gamo, rom araa daojaxebuli.

25
CamovweroT aTi sityva, romelic pirveli gagvaxsendeba, roca gvesmis
sityva “martoxela”, “Sinabera” an “berbiWa”.

• Tu aqvs sityva “martoxela”-s ase bevri negatiuri mniSvnelobis mqone

asociacia? ratom?
• Tqveni azriT, sazogadoeba martoxela mamakacs da martoxela qals
sxvadasxvanairad ganixilavs? ratom?
• rogor SeiZleba iqonios gavlena martoxela adamianebze sxva
adamianebis stereotipebma da molodinebma?
• ra aris martoxela cxovrebis saukeTeso mxare?

II. ojaxis cikli

pirveli movlena am ciklSi aris individis mier mSoblebis ojaxis
datoveba. es SeiZleba moxdes daqorwinebis momentSi an ufro adre, roca
adamiani gadawyvets icxovros martom an sxva adamianTan erTad. meore
mniSvnelovani movlenaa qorwineba da Semdgomi adaptacia axal adamianTan
an axal naTesavebTan. mesame yvelaze tipiuri movlenaa pirveli Svilis
dabadeba da mSoblobis periodis dawyeba. ojaxis cxovrebis ciklSi sxva
mniSvnelovani movlenebicaa: pirveli Svilis skolaSi wasvla, bolo
bavSvis dabadeba, bolo bavSvis ojaxidan wasvla da erT-erTi meuRlis
sikvdili. gafarToebul ojaxSi, romelic uaxloes naTesavebs moicavs,
ramdenime aseTi ciklia. es ciklebi urTierTqmedeben da maTSi es
movlenebi meordeba, rac xels uwyobs individis adaptacias.
bolo 50-100 wlis ganmavlobaSi ojaxuri ciklebi Seicvala rogorc
droiTi struqturis, ise am movlenebis xasiaTis TvalsazrisiT.
adamianebi aramarto cxovroben ufro didxans, aramed Seicvala asaki,
rodesac isini aRweven ojaxuri ciklis sxvadasxva safexurs. magaliTad,
gaizarda dro bolo bavSvis ojaxidan wasvlasa da mSoblebis pensiaze
gasvlas an maT sikvdils Soris. es "postmSoblobis" periodi gamudmebiT
izrdeba.

mSobloba
adamianebis umravlesoba mSobeli xdeba adreul zrdasrulobaSi. es
axali socialuri statusia da maTgan dedisa da mamis rolebis
Sesrulebas, axali pasuxismgeblobis aRebas iTxovs.
mSoblobaze gadasvla umniSvnelovanesia ojaxur ciklSi. col-
qmruli urTierTobisgan gansxvavebiT, adamiani ufro xSirad ganagrZobs
mSoblis rolisa da movaleobebis Sesrulebas maSinac ki roca misi
cxovrebis garemoebebi icvleba. mSobloba moiTxovs seriozul

26
cvlilebebs da SezRudvebs pirad cxovrebaSi. axaldaqorwinebulebs
xSirad SeuZliaT bevri ramis ufleba miscen sakuTar Tavs, gansakuTrebiT
roca orive muSaobs: yiduloben manqanebs, avejs, tansacmels, dadian
restornebSi, aqtiurad isveneben. magram roca ojaxSi Cndeba pirveli
bavSvi, cxovrebis aseTi wesi icvleba.
bavSvis gaCenasTan erTad mkveTrad izrdeba fizikuri da emociuri
datvirTva mSoblebze. irRveva Zili da cxovrebis Cveuli ritmi,
finansuri xarji, aris daZabuloba da gaRizianeba funqciebis
gadanawilebis Taobaze. deda gadaRlilia, mama Tavs uaryofilad
grZnobs, da orive ganicdis Tavisuflebis Sezrudvas. ojaxis axali
wevris gaCena asustebs kavSirs col-qmars Soris.
mSoblobaze gadasvla, Cveulebriv, xasiaTdeba Semdegi movlenebiT:
• cvlileba identobaSi da Sinagan cxovrebaSi. icvleba mSoblebis me-s
gancda da maTi ojaxur cxovrebasTan dakavSirebuli molodinebi;
• xelaxla gadanawildeba rolebi da icvleba col-qmruli
urTierTobebi. roca orive gatanjulia uZilobiT da imiT, rom ar
SeuZliaT erTad yofna, maT cxovrebaSi xdeba cvlilebebi, romlebic
dakavSirebulia Sromis ganawilebasTan;
• ufrosi Taobis rolebisa da damokidebulebebis cvlilebebi .
mSoblobaze gadasvla exeba mSoblebsac da bebia-babuebsac. maTi
qcevebic icvleba.
• rolebisa da damokidebulebebis cvlileba ojaxis gareT . gare
cvlilebebi exeba ZiriTadad dedas, radgan mas uxdeba samuSaos
datoveba, droebiT mainc, rom bavSvs mouaros.
• mSoblis roli aCens axali damokidebulebebs. meuRleebma unda aiRon
bavSvis aRzrdasTan dakavSirebiT axali movaleobebi.
kvlevebma aCvena, rom orsulobis periodSi, orive mSobels Seaqvs
koreqtivebi Tavis cxovrebaSi: mSobiarobasTan dakavSirebuli sakiTxebis
gadaWra, saxlis momzadeba patarasTvis, ganagrZon Tu ara muSaoba orivem
da sxv. xSirad momaval mSoblebs awuxebT SeZleben Tu ara maTTvis
axali rolis Sesrulebas da rogori iqneba maTi Svili. am periodSi
meuRleebi, Cvelebriv, emociur mxardaWeras aRmouCenen erTmaneTs.
miuxedavad imisa, rom bevri saerTo ram aqvT gasakeTebeli, dedebi
da mamebi gansxvavebulad reagireben pirveli bavSvis dabadebaze. qalebi,
rogorc wesi, cvlian Tavisi cxovrebis wess, aZleven ra prioritets
mSoblis da ojaxur rolebs. mamakacebi ki ufro xSirad iwyeben ufro
met muSaobas, rom ukeT uzrunvelyon ojaxi. bavSvis gaCena xdeba mizezi
axali stresebis da siZneleebis. rolebis Secvla xdeba sakmaod
moulodnelad. orive mSobeli grZnobs uCveulo siamayes da mRelvarebas
romelsac erTvis gazrdili pasuxismgeblobis grZnoba, zogjer Zalian
didic da amitom damTrgunvelic. zogierT mamakacs Surs Tavisi meuRlis,
27
romelsac SeuZlia bavSvis gaCena da mWidro emociuri kavSiris damyareba
CvilTan. meuRleebi iZulebuli xdebian Seamciron erTmaneTisTvis da
sakuTari interesebisTvis gankuTvnili dro. Cndeba xolme komunikaciuri
da seqsualuri xasiaTis problemebic, ufro xSiria konfliqtebic.
da mainc pirveli bavSvis dabadeba aris ufro ojaxis axal
mdgomareobaSi gadasvla, vidre krizisi. mSoblebis axal rolebTan
Seguebaze mravali faqtori axdens gavlenas. dedisTvis gadamwyveti
mniSvneloba aqvs socialur mxardaWeras, gansakuTrebiT meuRlis mxridan.
col-qmruli bedniereba orsulobis periodSi aseve mniSvnelovani
faqtoria, rom meuRleebi ukeT Seeguon axal situacias. mSobiarobis
Semdgom periodSi mSoblebis adaptaciaze gansakuTrebul gavlenas axdens
deda rogor afasebs col-qmrul urTierTobebs da Tavis orsulobas.
mSoblebis TviTSefaseba aseve asrulebs rols _ visac ufro maRali aqvs
TviTSefaseba, rogorc Cans Seguebac eadvileba. mniSvnelovania bavSvis
Taviseburebebic. visac rTuli bavSvi hyavs, maTTan ufro SeimCneva
daukmayofilebloba col-qmruli urTierTobebiT. mSoblebis asaki
bavSvis gaCenis momentisTvis aseve gavlenas axdens axal rolebTan
Seguebaze.

bavSvis aRzrda d mSoblis rolis Secvla.

ojaxuri ciklis yoveli periodi gamoirCeva specifiuri
moTxovnebiT mSoblebisadmi. Cvili iTxovs mudmiv yuradRebas. zogisTvis
es advili gasakeTebelia, zogisTvis _ ara. zog mSobels SeiZleba
amZimebdes bavSvis saWiroebebze Zlieri damokidebuleba. zogierTi,
magaliTad ver itans bavSvis tirils (bavSvis tirilma SeiZleba
gamoiwvios mamaSi an dedaSi ususurobis, damokidebulebis gancda an
gabrazeba). zogi mSobeli ki TandaTan eCveva, rom sxvaze iyos
damokidebuli da miaCnia es normalur, bunebriv moTxovnilebad.
bavSvisTvis yoveli kritikuli periodi qmnis an iwvevs kritikul
periods mSoblebisaTvisac. galinski (1980) aRwers mSoblobis 6 stadias:
• xatis formirebis stadiaze (bavSvis Casaxvidan dabadebamde periodSi)
mSoblebi cdiloben warmoidginon rogori mSoblebi iqnebian da
adareben Tavis molodinebs idealuri mSobelis xats.
• Cvilobis stadiaze (bavSvis dabadebidan 2 wlamde _ sanam ar iswavlis
"ara"-s Tqmas) mSoblebs uyalibdebaT mijaWvulobis grZnoba Tavisi
Svilisadmi, isini swavloben rogor gadaanawilon dro da emociuri
CarTuloba meuRlis, samsaxuris, megobrebis, sakuTari mSoblebisa da
bavSvis moTxovnilebebs Soris.
• avtoritetis stadiaze (roca bavSvi daaxloebiT 2-5 wlisaa) meuRleebs
uCndebaT kiTxva rogori mSoblebi iyvnen da rogorebi iqnebian.
progresi aris im SemTxvevaSi, roca mSoblebi acnobiereben, rom isini
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 _ da maTi Svilebi _ yovelTvis ar Seesabamebian maT mier Seqmnil
idealur xats.
• interpretaciis stadiaze (roca Svili daaxloebiT saSualo bavSvobis
asakSia) mSoblebi iZulebuli xdebian Seamowmon da gadaamowmon Tavisi
ukve Camoyalibebuli Sexedulebebi.
• rodesac maTi Svilebi xdebian mozardebi, mSoblebi gadian
urTierTdamokidebulebis stadias, romelzec maT unda gadaxedon
Tavis mbrZanelur damokidebulebas axla ukve TiTqmis zrdasruli
Svilebisadmi. es urTierTobebi SeiZleba gaxdes
urTierTdapirispirebuli an partnioruli xasiaTis.
• dabolos, ganSorebis stadiaze Svilebi midian ojaxidan, mSoblebs
uwevT aramarto maTi "gaSveba", aramed kritikulad gaazreba imis, Tu
rogori mSoblebi iyvnen. yovel stadiaze mSoblebma unda gadaWran
Sinagani konfliqtebi axal da ufro maRal doneze, Torem es
daZabuloba SeiZleba uaryofiTad aisaxos col-qmrul urTierTobebze
da mSoblis funqciis efeqtianad Sesrulebaze.
Tumca mSobelma, romelic ver axerxebs bavSvebTan Sewyobas maTi
ganviTarebis romelime stadiaze, SeiZleba warmatebiT gaakeTos es sxva
stadiaze. magaliTad, SeiZleba mSobels gauWirdes Cvil bavSvTan
urTierToba, magram kargad gamouvides es skolamdelTan an mozardTan.
SesaZlebelia piriqiTac moxdes _ patarasTan sakmaod Tavdajerebulia,
magram mozardTan uamravi problema gauCndes.
ojaxuri ciklis yovel stadiaze mSoblebs uxdebaT gamklaveba
aramarto maTi Svilebis ganviTarebasTan dakavSirebul problemebTan. maT
aseve unda moagvaron col-qmars Soris da ojaxSi arsebuli problemebic.
ojaxurma wyvilma siZneleebi da konfliqtebi unda daZlios
uerTierTpativiscemis meSveobiT. ojaxi rogorc sistema, romelSic erTs
mudam dominanturi mdgomareoba aqvs, meore ki Tavs msxverplad swiravs,
dros ver uZlebs. ojaxuri sistema unda iyos moqnili, dinamiuri, axal
pirobebTan (magaliTad, roca mozardi Svili iTxovs damoukideblobas
rogorc pirovneba) adaptirebadi. xisti da nakleb struqturirebuli
sistema advilad iSleba da ver akmayofilebs bavSvis moTxovnilebebs.

martoxela mSoblebi. aseTi mSoblebis didi umravlesoba aris

momuSave dedebi. raodenoba ojaxebisa erTi mSobliT saocari siswrafiT
izrdeba. 1993 wlisTvis aSS-Si yovel meoTxe ojaxs inaxavda martoxela
deda. ram gamoiwvia aseTi tendencia? aSS-Si 60-70-ian wlebSi es
dakavSirebuli iyo ganqorwinebis matebasTan _ 15 wlis ganmavlobaSi
martoxela dedebis raodenobam 70 %-iT moimata. ganqorwinebebma piks
miaRwia 1979 da 1981 wels. mere TandaTan daiwia. meore faqtoria im
martoxela dedebis raodenobis zrda, romlebic arasdros yofilan
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daqorwinebuli. amasTan, gaizarda im bavSviani qalebis raodenobac,
romlebic cxovroben qmrebisgan calke, moSorebiT.
rosi da sohili am tendenciebis zrdas ukavSireben qalebis
socialuri da ekonomikuri mdgomareobis gaumjobesebas. marTlac,
garkveuli wlebis manZilze mainc, qalebs aRar uWirT marto ojaxis
Senaxva, Tumca bevri maTgani xelmeored Txovdeba da qmnis ojaxs.
martoxela dedebi, rogorc wesi, Souloben naklebs vidre
martoxela mamebi. gansakuTrebiT uWirT im qalebs, romelTac ar aqvT
ganaTleba miRebuli. martoxela dedebis ojaxebSi ufro xSiria siRaribe
(gansakuTrebiT afroamrikelTa Soris da espanuri warmoSobis
amerikelebs Soris).
marTalia cotaa martoxela mamebis ricxvi, magram maTi raodenoba
TandaTan mainc izrdeba. es aris ZiriTadad ganqorwinebuli an
daqvrivebuli mamakacebi. martoxela mamebi bevr rameSi iseTive siZneleebs
awydebian, rogorc martoxela dedebi. Tumca maTi finansuri mdgomareoba
ufro myaria. isinic ganicdian martoobas da daTrgunulobas, maTac
uWirT megobrebis wris SenarCuneba da sxva saxis emociuri mxardaWeris
povna.

November 17, 2015

Mother's Age at Birth May Influence Symptoms of Depression In Daughters

Father’s age not a factor; effect not seen in sons, study says

Read the journal article

• Older Maternal Age Is Associated With Depression, Anxiety, and Stress

Symptoms in Young Adult Female Offspring (PDF, 184KB)

WASHINGTON — The daughters, but not the sons, of women who give birth at age 30
or older are more likely to experience symptoms of depression as young adults,
according to research published by the American Psychological Association.

“This study suggests that older maternal age is associated with symptoms of
depression, anxiety and stress in young adult females,” said Jessica Tearne, a doctoral
student at the University of Western Australia and lead author of the study. It appears in
the Journal of Abnormal Psychology®.

Tearne and her colleagues analyzed data from the Western Australian Pregnancy
Cohort (Raine) Study. From 1989-91, pregnant women were recruited into this study,

30
and provided psychological and demographic information. The resulting offspring then
underwent psychological assessment at various ages over the next 23 years.

In this study, the researchers looked at self-reported levels of various symptoms of

depression, anxiety and stress from 1,200 of the offspring at age 20 and compared them
with the age of the mother and father at the time the children were born. Daughters
whose mothers were age 30 to 34 when they gave birth reported significantly higher
levels of stress and those whose mothers were over age 35 at the time of birth had
significantly higher levels of stress, depression and anxiety compared with daughters
whose mothers were under age 30.

While 5 percent of the mothers were under age 20 when they gave birth, there was no
effect for giving birth in that age group. The fathers’ age at the time of birth also had no
effect, and there was no effect found for sons.

While the exact cause of this relationship is not clear, Tearne said she suspects it is not
necessarily biological.

“One hypothesis is difficulties may occur in the mother-daughter relationship because of

a large age difference between the two,” said Tearne. “It may be that a 30 or more year
age difference between mother and daughter leads to a significant difference in the
value systems that may cause tensions in the relationship, leading to stress, worry and
sadness in the child, particularly during the transition to young adulthood.”

Another possible explanation may be that the women who gave birth over age 30 would
be in their 50s at the time their children were assessed and therefore more likely to be
experiencing health problems associated with aging. This could also lead to higher
levels of symptoms in the children, Tearne said. Other studies have suggested that
daughters are more affected by their mother’s health problems than sons, which could
explain why the effect only appears in daughters, she said.

“It is important to remember, too, that the study examined symptoms of distress, rather
than clinical diagnosis,” said Monique Robinson, PhD, of the University of Western
Australia, another author of the study. “It could be that the offspring of older mothers are
at risk for a few more symptoms of depression, anxiety and stress, but that does not
necessarily mean they will experience a diagnosable mental disorder.”

Article: “Older Maternal Age is Associated with Depression, Anxiety and Stress
Symptoms in Young Adult Female Offspring,” by Jessica Tearne, BA, Monique
Robinson, PhD, Peter Jacoby, MSc, Karina Allen, PhD, Nadia Cunningham, BA, and
Neil McLean, MA, The University of Western Australia, and Jianghong Li, PhD, WZB
Berlin Social Research Center, Journal of Abnormal Psychology, published online Nov.
16, 2015.

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Mom’s Attitude Can Affect Dad’s Parenting
August 6, 2015August 6, 2015 sluapaLeave a comment

To get fathers to be more involved with their children, mothers should encourage dads to play a
bigger role in their children’s upbringing — and then remember to step back and let them do just
that, according to presenters Thursday at a symposium on fathers’ parenting patterns during the
2015 APA Annual Convention in Toronto.

Instead, some 21 percent of mothers engage in what’s known as “maternal gatekeeping,” where
they might consciously or unconsciously dissuade fathers from helping with child-related chores
or activities, or just do the tasks themselves, said Alex Rowell, a doctoral student at Ohio
University, who presented at the symposium, “A Quantitative Evaluation of New Fatherhood:
Implications for Policy and Practice.” That’s partly because of society’s expectations, standards
and social validation of child-rearing duties, he said. And it can lead to dads taking a lesser role
in parenting.

“[Maternal gatekeeping] affects paternal abilities,

as in how confident fathers are in being able to do tasks like changing diapers or arranging
playdates,” Rowell said. “There’s not that reinforcement of confidence, so [he might] start
withdrawing a little bit.” Other barriers may include gender role conflict, professional biases and
work-life balance, anxiety and feelings of low self-efficacy when it comes to parenting.

Still, dads have a greater role in parenting than is often thought, and their interaction with their
children can have a big influence on how those children develop. According to what’s called the
activation relationship theory, fathers interact with children differently than do mothers. They can
help their children learn how to safely explore the world, and they bring a playful attitude to
parenting that helps kids learn about appropriate social behavior.

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“The central nervous system is spiked a little more through rough-and-tumble play, and the child
has to learn to self-regulate,” Rowell said. Other studies suggest that a father’s involvement at
various ages can protect against negative psychological conditions and influence a child’s motor
development, school readiness and IQ.

Psychologists still are trying to tease out how family, mental health and social factors come into
play for new fathers and to develop measures for their involvement, said Brian Cole, PhD, an
assistant professor at Seton Hall University.

“Parenting doesn’t occur in a vacuum, and there’s no manual,” Cole said. “When you pair that
with gender norms that discourage men from taking an active role in parenting, it’s important to
understand what processes encourage men to actively engage in it.” Research so far suggests
that social support is a significant factor.

Researchers in the field also are studying how these relationships play out with single- or same-
sex parents.

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 profesiuli cikli

profesiuli cikli iwyeba fiqriT momavalze jer kidev mozardobis asakSi, rasac
individi miyavs profesiis arCevamde, grZeldeba samsaxuriT arCeuli profesiis mixedviT
da mTavrdeba pensiaze gasvliT. am periodSi adamians gamudmebiT uxdeba
gadawyvetilebebis miReba, xdeba mniSvnelovani movlenebi, aris eWvebisa da gansacdelis
periodebic.
profesiuli gzis etapebi. superisa da heivigherstis azriT, SeiZleba gamoiyos
profesiuli ganviTarebis xuTi etapi:
1. zrdis etapi (dabadebidan 14 wlamde). am periodSi bavSvebi mosinjaven Tavis
SesaZleblobebs rolebiT TamaSis dros. sxvadasxva mecadineobebze Tu
klasgareSe aqtivobaSi isini acnobiereben ra moswonT, ra gamosdiT kargad,
Cndeba garkveuli sferoebisadmi interesebi, romlebmac SeiZleba gavlena
moaxdinos profesiis arCevanze;
2. Ziebis etapi (15-24 ww). axalgazrdebi cdiloben gansazRvron Tavisi interesebi,
unarebi, SesaZleblobebi, SearCion profesia da daeuflon mas;
3. karieris ganmtkicebis etapi (25-44 ww), rodesac individebi cdiloben myari
mdgomareobis dakavebas maT mier arCeul profesiul sferoSi;
4. miRweulis SenarCunebis etapi (45-64 ww)
5. karieruli ukusvlis, dacemis etapi (65 wlis Semdeg ). adamianis fizikuri da
kognituri unarebi sustdeba am asakisTvis, rac iwvevs SromiTi saqmianobis
xasiaTis Secvlas da bolos mis Sewyvetas.
Tanamedrove swrafad cvalebad, maRalteqnologiur sazogadoebaSi yvela ar
gadis erTi da igive TanmimdevobiT am etapebs, miTumetes yvela profesiaSi erTnairad.
axalgazrdebi xSirad icvlian samuSaos, sanam saboloo arCevans gaakeTeben.
mowifulobaSic bevri icvlis samuSao adgils rom hqondes ukeTesi anazRaureba,
Tanamdeboba, samuSao pirobebi. zogi ki iZulebulia Seicvalos samuSao SromiT bazarze
arastabiluri situaciis, Tu cudi ekonomikuri mdgomareobis gamo.
adamianebs, romlebic samuSaodan daiTxoves an aiZules pensiaze gasvla, xSirad
aqvT emociuri problemebi. Suaxnis asakSi samuSaos dakargva SesaZloa ufro mZime iyos,
vidre SedarebiT axalgazrdebisTvis, radgan adamiani:
a) kargavs simyarisa da stabilurobis gancdas;
b) rac metia asaki, miT naklebia sxva samuSaoze an gadasamzadebel kursebze miRebis
albaToba;
g) Tu mainc moxerxda axali samuSaos moZebna, is, Cveulebriv, nakleb prestiJuli da
naklebad anazRaurebadia.

profesiis arCeva da profesiuli momzadeba. profesiis arCevaze mravali faqtori

moqmedebs: socio-ekonomikuri statusi, eTnikuri mikuTvnebuloba, inteleqti, specialuri
unarebi (magaliTad musikaluri an maTematikuri niWiereba), sqesi da mSoblebis
profesia. superic da heivigherstic Tvlian, rom ukve 15 wlis asakisTvis adamianebs aqvT
savaraudo monaxazi, gegma Tavisi karierisa da cdiloben Sesabamisi unarebis da
xasiaTis Tvisebebi ganiviTaron.
sqesi da rasa. qalebi da zogierTi rasis an eTnikuri jgufebis warmomadgenlebi
garkveul profesiebSi metad arian CarTuli, zogSi _ naklebad. ra ganapirobebs amas?

34
 mSoblebis ganwyobebi. ojaxi gavlenas axdens bavSvis mier profesiis arCevanze,
radgan mSoblebi warmoadgenen axalgazrdisTvis garkveuli cxovrebis wesisa da
mniSvnelovani cxovrebiseuli Rirebulebebisa da rwmenebis formirebis models.
magaliTad, momuSave dedebis qaliSvilebs ufro maRali aqvT miRwevis motivacia da
profesiuli karieris gakeTebis survili, vidre aramomuSave dedebis qaliSvilebs.
me-koncefcia. am Teoriis Tanaxmad adamianebi irCeven im profesias, romelic
Seesabameba maT warmodgenebs sakuTar Tavze. me-koncefciis Sesabamisi profesiis
meSveobiT isini aRweven TviTaqtualizacias. isini akeTeben imas, rasac, maTi azriT,
SeuZlia yvelaze metad moutanos maT kmayofileba da maqsimalurad Seuwyos xeli maT
pirovnul ganviTarebas.
pirovnuli Tvisebebi. am Teoriis Tanaxmad arsebobs kargi Sesatyvisoba adamianis
mier arCeul saqmianobasa da mis pirovnul Tvisebebs Soris. holandma SeimuSava
Sesaferisi profesiis SerCevis sistema pirovnebis 6 Tvisebis mixedviT. esenia:
realisturoba, cnobismoyvareoba (pitlivost), komunikabeluroba (obSitelnost),
normebisa da wesebis ganuxrelad dacva, iniciativianoba, artistuloba. adamiani,
romelic gamokveTilad aris cnobismoyvare da iniciativiani, SeiZleba gaxdes mecnieri,
is ki vinc aris komunikabeluri da mkacrad icavs normebs da wesebs, SeiZleba gaxdes,
magaliTad, medda.
praqtikuli mosazrebebi. ekonomikuri krizisis da masiuri umuSevrobis periodSi
adamians SeiZleba ar hqondes arCevanis saSualeba da SeiZleba mouxdes im profesiis
arCeva, romelic samuSaoTi uzrunvelyofs. arcTu iSviaTia, rodesac adamiani ocnebobs
arqiteqtorobaze, magram xdeba buRalteri an saqmeTa mmarTveli. arsebobs aseve meuRlis
daxmarebis an ojaxis Senaxvis aucilebloba, rac aiZulebs adamians airCios sul sxva
saqmianoba. amrigad, praqtikuli mosazrebebic kargad xsnis ratom SeiZleba airCios
individma esa Tu is profesia.

profesiuli adaptacia.
molodinebi da realoba. WabukobaSi da profesiuli ganaTlebis miRebis periodSi
adamianebs aqvT naTeli, optimisturi molodinebi momaval saqmianobaze. magram roca
iwyeba yoveldRiuroba da rutina, axalgazrda male acnobierebs, rom SeiZleba
yvelaferi ise ar gamovides, rogorc surda. samuSao SeiZleba aRmoCndes mosawyeni da
meqanikuric, xelmZRvanelebi _ usamarTlo, TanamSromlebTan urTierToba rTuli. aman
SeiZleba gamoiwvios frustracia (imedgacruebis mdgomareoba) sanam ar Seegueba axal
garemos. Tu axalgazrdam ver moaxerxa adaptacia, SeiZleba xeli SeeSalos profesiul
zrdaSi.
damrigeblis roli. levinsoni xazs usvams damrigeblis rols profesiuli
daostatebis saqmeSi _ isini uadvileben axalgazrdas damoukidebel, kompetentur
specialistad Camoyalibebas. axalbeda damrigeblis mzrunvelobis qveS yofnisas iZens
gamocdilebas da ufro dajerebulia sakuTar ZalebSi. male is mTlianad egueba Tavis
samuSao adgils da SeiZleba raRacaSi ajobos kidec damrigebels da aRar saWiroebdes
mis daxmarebas. Semdeg is TandaTan iZens avtoritets TanamSromlebSi da SeiZleba
Tavadac gaxdes damrigebeli sxva axalgazrdisTvis.
administraciuli da samecniero saqmianobiT dakavebuli mamakacebi xSirad
aRniSnaven, rom hyavdaT damrigebeli. magram am sferoSi adamianebis didi raodenoba
araa dakavebuli. Tanac administratori qalebis umravlesoba ambobs, rom maT ar
hyavdaT stabilurad erTi damrigebeli. zogi qali aRniSnavs, rom maTi damrigebeli iyo
qmari. magram amas SeiZleba mohyves problemebic. rodesac qalis profesiuli kariera
xels uSlis mas uwindeburad didi dro dauTmos meuRles da ojaxs, qmrebi xSirad

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uars eubnebian xolme mas daxmarebaze da mxardaWeraze. rodesac qalis damrigebeli
aris ucxo mamakaci, amanac SeiZleba gaaCinos sirTuleebi.
genderuli sxvaobebi. marTalia, zogierTi qali profesiul karieraSi gadis igive
safexurebs, rasac mamakacebi, mainc qalebis umravlesoba cdilobs SeaTavsos samsaxuri
ojaxur movaleobebTan. zogi samuSaos tovebs, roca bavSvebia gasazrdeli, zogi
arasruli dRe muSaobs, sxvebi saxlSi muSaobiT cdiloben ojaxis biujetis Sevsebas.
ekonomikuri sirTuleebis periodebSi qalebs yovelTvis uxdebodaT saxlis gareT
muSaoba, garkveuli drois ganmavlobaSi mainc. XX saukunis 60-iani wlebidan
mniSvnelovnad gaizarda momuSave qalebis raodenoba. qalebis mniSvnelovani nawili
mamakacebiviT mTeli cxovreba muSaobs. magram qalebis didi nawilisTvis profesiuli
ganviTareba da saqmianoba araa erTgvarovani procesi. qalebis umravlesoba wyvets
profesiul karieras cota xniT mainc, rom aRzardos Svilebi, maSin roca mamakacebi ase
Zalian iSviaTad iqcevian. zogierTi karieraSi warmatebis miRwevis Semdeg gadawyvets
xolme bavSvebis gaCenas da Tavs anebebs samsaxurs. zogierTi Tavidan Tavs uZRvnis
ojaxs da bavSvebis aRzrdas da Semdeg iwyebs muSaobas _ Cveulebriv, roca umcrosi
bavSvi midis skolaSi. qalebi, iseve rogorc mamakacebi, muSaobas iwyeben sxvadasxva
mizezis gamo. ZiriTadi mizezi SeiZleba iyos ekonomikuri aucilebloba, gansakuTrebiT
martoxela dedebis SemTxvevaSi. xSirad qalebs imdenive SemoaqvT ojaxis biujetSi,
ramdenic kacebs. magram aris sxva mizezebic. qalebi profesiul saqmianobaSi xedaven
sakuTari Tavis da Zalebis realizebis saSualebas, Tvlian mas saintereso da
SemoqmedebiT saqmed.
Tumca aris gansxvavebac momuSave qalebsa da mamakacebs Soris. ramdenime kvlevam
aCvena, rom qalebi ufro xSirad aRniSnaven Tavis saqmianobaSi adamianebTan _
klientebTan, TanamSromlebTan, xelmZRvaneleTanac ki _ urTierTobis mniSvnelobas.
ojaxis miRma socialuri urTierTobebi aZlierebs maTSi sxva adamianebTan erTianobis
grZnobas.
zogadad, momuSave qalebi aramomuSaveebisagan gansxvavdebian ufro myari
fizikuri da fsiqikuri janmrTelobiT. maT nakleb awuxebT depresia, gulis da
wylulovani daavadebebi. ufro pativs scemen sakuTar Tavs (gansakuTrebiT
dauqorwinebeli qalebi). rac metia qalis profesiuli kvalifikacia, miT metia
samsaxuriT kmayofilebis gancda, miuxedavad didi datvirTvebisa.
aris meore gansxvavebac. qalebSi mkveTrad gansxvavdebian isini, vinc
orientirebulia karieraze maTgan, visTvisac samsaxuri araa mTavari. erTerTi kvlevis
mixedviT, samuSaoze orientirebulTa Soris droebiT an dabal Tanamdebobaze momuSave
qalebs naklebi qondaT kmayofileba, Tavisi Tavis pativiscema da darwmunebuloba
sakuTar SesaZleblobebSi. amis sapirispirod, vinc ar iyo orientirebuli samuSaoze,
maTi sakuTari Tavis pativiscema da cxovrebiT kmayofileba ar iyo damokidebuli imaze,
srul dRes muSaobden Tu arasruls, droebiTi iyo samuSao Tu stabiluri da ra
Tanamdebobaze imyofeboden.

zrdasruli adamianis cxovrebis levinsoniseuli periodizacia

levinsonma Caatara zrdasrulobis periodSi adamianis ganviTarebis CaRrmavebuli

kvleva. man SearCia 40 mamakaci 35-45 wlis asakis sxvadasxva rasis, eTnikuri jgufis da
profesiis. ramdenime Tvis SualediT axdenda maT interviurebas. mis mier Sekrebili
informacia dafuZnebulia respodentebis mogonebebze da TviTanalizze da ufro
subieqturia, vidre sxva mkvlevarebis mier Skalebisa da "brmad Sefasebis meTodiT"

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mopovebuli informacia. cdispirTa rekonstruirebul biografiebTan erTad levinsonma
Seiswavla iseTi gamoCenili adamianebis biografiebic, rogoricaa dante da gandi.
mamakacis cxovrebiseul ciklSi man gamoyo 3 mTavari era. TiToeuli 20 wlis
xangrZliobiT. cxovrebis struqtura iqmneba individis gare samyarosTan ormxrivi
urTierTobiT. es SeiZleba iyos urTierTobebi calkeul adamianebTan, jgufebTan,
sistemebTan, da sagnebTanac ki. mamakacebis umravlesobisTvis centralur adgils ikavebs
urTierTobebi _ samsaxurebrivi da ojaxuri. garkveul asakobriv periodebSi adamianebs
uCndebaT eWvebi da iwyeben cxovrebis arsebuli struqturis ngrevas. Semdeg isini qmnian
axal struqturas, romelic Seesabameba maT mimdinare moTxovnilebebs. es struqtura
aris dominanturi xangrZlivi periodis ganmavlobaSi sanam adamiani isev ar iwyebs
cvlilebebs da procesi meordeba.
marTalia levinsons Tavidan ainteresebda 35-45 wlis asaki (cxovrebis Suaxanis
aTwleuli), man aRmoaCina, rom am stadiaze srulfasovani ganviTareba da adaptacia
mniSvnelovnad aris damokidebuli 17-33 wlebis asakSi momxdari wamowyebebze. es aris
periodi, rodesac axalgazrdebi eZeben Tavis adgils sazogadoebaSi, iReben
pasuxismgeblobas romelic gulisxmobs cxovrebis stabilur, advilad ganWvretad
dinebas. wamowyebebis periodi levinsonma dayo 3 qveperiodad: gadasvla adreul
zrdasrulobaze, (daaxloebiT 17-22 wlebi); zrdasrulebis samyaroSi Sesvla (22-28
wlebi) da gadasvla 30 wlis asakis (28-33 wlebi). levinsonis Tanaxmad, imisaTvis, rom
srulad gaxde zrdasruli, mamakacma unda gadawyvitos 4 amocana: 1) ocnebebi miabas
realobas; 2) monaxos damrigebeli (nastavnik); 3) uzrunvelyos Tavisi kariera da 4)
moagvaros intimuri urTierTobebi.

gadasvla gvian zrdasrulobaze: 60-65 ww

struqtura cxovrebis saSualo zrdasrulobis kulminaciur periodSi: 55-60 ww

50 wlis gadasvla: 50-55 ww

struqtura cxovrebis saSualo zrdasrulobis periodis dasawyisSi: 45-50 ww

gadasvla saSualo zrdasrulobaze: 40-45 ww

struqtura cxovrebis adreuli zrdasrulobis kulminaciur periodSi: 33-40 ww

gadasvla 30 wlis zRvaris: 28-33 ww

struqtura cxovrebis adreul zrdasrulobaSi Sesvlis periodSi: 22-28 ww

gadasvla adreul zrdasrulobaze: 17-22 ww

bavSvobisa da mozardobis periodi: 0-22 ww

mamakacis cxovrebis periodizaciis Taviseburebebi

ocnebebi da realoba. sawyis etapze zrdasrulTa ocnebebi sustad aris
dakavSirebuli realobasTan. ocneba SeiZleba iyos konkretuli mizani, magaliTad
nobelis premiis miReba an romelime socialuri rolis aRebis pretenzia - gaxdes
reJisori, magnati an saxelovani poeti. mamakacebi SeiZleba iyon ufro zomierebic
ocnebebSi, magaliTad gaxden kargi xelosani an Seqmnan bednieri ojaxi. ocnebis yvelaze
mTavari aspeqtia misi unari STaagonos mamakaci axlandel saqmianobaSi. idealur
SemTxvevaSi axalgazrda kaci iwyebs Tavisi cxovrebis struqturis agebas, realobis
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gaTvaliswinebiT yvelafers ganixilavs gonivruli optimizmiT, rac exmareba ocnebis
realizebaSi. usafuZvlo fantaziebi da sruliad miuRwevadi miznebi xels ar uwyobs
zrdas.
rodesac ocneba realisturia, SeiZleba mainc ver moxdes misi realizeba
xelsayreli SesaZleblobebis an specialuri unarebis ar qonis gamo, mSoblebis mxridan
zedmeti zewolis an iseTi pirovnuli Tvisebebis gamo, rogoricaa danaSaulis grZnoba
an pasiuroba. amis Sedegad axalgazrda kacma SeiZleba airCios da daeuflos profesias,
romelic misTvis ar aris momxiblavi. levinsonis mixedviT aseTi gadawyvetilebebi xdeba
wyaro mudmivi profesiuli konfliqtebisa zrdasrulobis xanaSi, SeiZleba ar qondes
SromiTi enTuziazmi da dabali SromiTi realizeba. levinsoni Tvlis, rom adamianebs,
romlebic ibrZvian raime ocnebisTvis, misi asrulebis grZnobis gancdis albaToba meti
aqvT. mniSvnelovania aRiniSnos, rom TviTon ocnebac icvleba. axalgazrda kaci,
romelic Tavidan ocnebobs gaxdes cnobili fexburTeli, mogvianebiT SeiZleba
kmayofili iyos treneris muSaobiTac, nawilobriv mainc aixdens ymawvilkacobis ocnebas.
damrigeblis povna. ocnebis ganxorcielebaSi udidesi daxmareba axalgazrda kacs
SeiZleba gauwios damrigebelma (nastavnik). mas SeuZlia Caunergos darwmunebuloba,
gaiziarebs da mouwonebs ra mis ocnebas da gadascems ra Tavis cxovrebiseul
gamocdilebas da ostatobas. mfarvelis saxiT mas SeuZlia gavlena moaxdinos mis
warmatebul karierul svlaze. Tumca damrigeblis ZiriTadi funqcia imaSi mdgomareobs,
rom uzrunvelyos gadasvla “mSobeli_bavSvi” damokidebulebidan zrdasruli
Tanatolebis samyaroSi urTierTobebze. damrigebels unda hqondes sakmaod mSoblis
Tvisebebi, iyos gansaxiereba maRali miRwevebis da amavdroulad gamoavlinos
mowafisadmi TanagrZnoba da simpaTia, rom SeZlos gadalaxos gaTiSuloba Taobebs
Soris da daamyaros "TanaswoTa doneze" urTierTobebi. TandaTan mowafe iZens
damoukideblobisa da kompetenturobis grZnobas da droTa ganmavlobaSi SeiZleba
ajobos damrigebels. arcTu iSviaTia, rom damrigebeli da mowafe uecrad wyveten
urTierTobas da cildebian.
karieris ageba. ocnebis asrulebisa da damrigeblis SeZenis garda, axalgazrda
kaci xvdeba karieris agebis socio-fsiqologiur sirTuleebs. es cildeba profesiis
arCevis sakiTxs. levinsoni Tvlida, rom es aris ganviTarebis amocana am periodis.
eriksonis msgavsad, is ganixilavda karieris formirebis mravalferovan komponentebs
rogorc TviTgamorkvevis miRwevis saSualebas zrdasrulobis periodSi.
axlo urTierTobebis damyareba. zustad aseve, ojaxSi axlo urTierTobebis
damyareba ar Semoifargleba qorwinebiT da pirveli bavSvis dabadebiT. manamdec da
merec axalgazrda kaci avsebs Tavis gamocdilebas sakuTar Tavze da qalebTan
urTierTobaze. man unda gaarkvios TavisTvis, ris gamo moswons is qalebs da TviTon mas
ra moswons qalebSi: man unda gaigos Tavisi Zlieri da susti _ fsiqologiuri _
mxareebi seqsualur siaxloveSi. Tumca garkveuli warmodgena sakuTar Tavze man miiRo
ukve Wabukobis xanaSi, adreuli zrdasrulobis periodSi es sakiTxebi jer kidev
Semacbunebelia misTvis da iwvevs danaSaulis grZnobas. mxolod 30 wlis asakis
gadabijebis Semdeg uviTardeba mamakacs qalTan seriozuli, Tanasworuflebiani
partnioruli urTierTobis unars. garda amisa, sakuTar da sxvebis feminur mxareebTan
damokidebuleba mTeli cxovrebis manZilze rCeba ganviTarebis amocanad.
pirveli kavSiri gansakuTrebul qalTan (levinsonis terminia) emsaxureba imave
moTxovnilebebs, rasac urTierToba damrigebeli-mowafe. gansakuTrebul qals SeuZlia
xeli Seuwyos ocnebis ganxorcielebas, aiZulebs ra partniors Tavi igrZnos gmirad. is
exmareba axalgazrda kacs zrdaasrulTa samyaroSi SesvlaSi, mis imedebs aRvivebs da
iTmens mis damokidebul mdgomareobas da naklovanebebs. levinsonis Tanaxmad, mamakacis

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moTxovnileba gansakuTrebul qalSi qveiTdeba droTa ganmavlobaSi, Sua xnis asakisTvis,
roca mamakacebis umravlesoba aRwevs damoukideblobas da kompetenturobas.

qalis cxovrebis periodizaciis Taviseburebebi

levinsonis kvlevebs didi gamoxmaureba mohyva. sayvedurobden, rom qalebis
ignorireba moaxdina. ramdenime qalma (vendi stuarti, rut droeji, ketrin farsti, diana
adamsi) Caatares kvlevebi igive meTodikiT _ gamoiyenes biografiuli interviu. magram
maTi kvlevebi ar iyo imdenad masStaburi, rogorc levinsonis (naklebi cdispirebi
yavdaT da nakleb periods ikvlevden). TviTon levinsonmac Caatara kvleva 1990 wels. man
45 qali SearCia: 15_diasaxlisi, 15_saqmiani qali, 15_umaRlesi saswavleblis pedagogi.
zrdasruli qalebis cxovrebiseuli gzis es kvlevebi nawilobriv adastureben
levinsonis Teoriul hipoTezas, rom zrdasrulobaSi Sesvla dakavSirebulia 4
erTmaneTTan dakavSirebul amocanasTan: ocnebis Camoyalibeba, damrigeblis SeZena,
karieris formireba da gansakuTrebul adamianTan urTierTobebis damyareba da gadasvla
30 wlis asakis. 30 wlis gadasvlis periodi, levinsonis azriT, aris stresis periodi,
radgan am dros karieruli miznebis da cxovrebis wesis gadafaseba xdeba. am kvlevebma
isic aCvena, rom msgavsebis garda aris arsebiTi gansxvaveba mamakacebisa da qalebis
cxovrebiseul gzaSi. marTalia levinsoni amtkicebs, rom gadasvlis periodebi
qalebTanac da kacebTanac mWidrod ukavSirdeba asaks, sxva kvlevebis mixedviT
qalebisTvis ojaxuri ciklis stadiebi, rogorc Cans, ukeTesi indikatoria, vidre asaki.
qalebisTvis SeiZleba erTi asakobrivi periodidan meoreze gadasvlas migvaniSnebdes ara
30, 40 an 50 welis gadabijeba, aramed bavSvis dabadeba an Svilebis daojaxeba an
saxlidan wasvla.
gansxvaveba ocnebebSi. yvelaze gasaocari aris gansxvaveba qalebisa da mamakacebis
ocnebaSi. qalebisTvisac da kacebisTvisac ocnebas uWiravs centraluri adgili. magram,
Tu mamakacebis ocnebebi mTlianobaSi aris erTgvarovani xasiaTis, qalebis
ocnebebisTvis xSirad aris damaxasiaTebeli danawevrebuloba. levinsonis kvlevaSi
universitetSi da biznesSi momuSave qalebi cdilobden SeeTavsebinaT kariera da
gaTxoveba, magram akeTebden amas sxvadasxvanairad. pirvelebi iyvnen nakleb pativmoyvare
da ufro meti hqondaT mzaoba uari eTqvaT karieraze, radgan SeeZloT inteleqtualuri
samuSaos gagrZeleba bavSvis dabadebis Semdegac sxvadasxva sazogadoebrivi saqmianobiT.
saqmiani qalebi cdilobden samsaxuris SenarCunebas bavSvis dabadebis Semdegac, Tundac
nakleb Tanamdebobaze. mxolod diasaxlisebs hqondaT erTgvarovani ocneba: mTeli dro
mieZRvnaT ojaxisTvis _ rogorc amas maTi dedebi akeTebden.
ufro adre Catarebul kvlvebSic qalebis umravlesobis ocnebebi aseve moicavden
qorwinebas da karieras da maTi mniSvnelovani nawili met wonas aZlevda daqorwinebas.
mxolod 7 qali 39-dan (18%-ze naklebi) ukavSirebden Tavis ocnebebs mxolod
samsaxurebriv warmatebas da kidev ufro naklebi (15%-ze cota meti) Semoifargleboden
colis, dedis da damxmaris tradiciuli rolebiT samomavlod. Tumca is qalebic ki,
romlebic ocnebobden karierazec da daqorwinebazec, amcirebden Tavis ocnebebs qmrebis
interesebis gaTvaliswinebiT da tradiciul molodinebs adasturebden Tanamedrove
cxovrebis wesis farglebSi.
gamokvleul jgufSi Sedioden 28-dan 50 wlamde qalebi. gamokvlevis dros 75%
iyo daojaxebuli an ganqorwinebuli. daaxloebiT 41% maTgan gamoxatavda ukmayofilebas

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gaxleCili cxovrebis gamo. zogierTisTvis SeuZlebeli aRmoCnda karierisa da ojaxis
SeTavseba. levinsonis kvlevaSi qalebi aseve Tvliden, rom karierisa da ojaxis
SeTavseba uaRresad rTulia. saqmiani qalebidan yvela Tvlida rom es gadawyvetileba
maTTvis iyo "aucilebloba". miuxedavad imisa, rom maTi kolegebi da ojaxis wevrebi
Tvliden, rom am qalebma warmatebas miaRwies, TviTon es qalebi grZnobden, rom
msxverplad swiraven karieras ojaxisaTvis an ojaxs _ karierisTvis. diasaxlisebic ar
iyvnen Zalian bednierebi. 35-45 wlis asakSi maTi mxolod 20% iyo qorwinebaSi, 30% iyo
oficialurad ganqorwinebuli, 30% grZnobden Tavs "fsiqologiurad" gayrilad Tavis
qmrebTan, darCenili 20% cdilobda ganesazRvra ramdenad mniSvnelovania maTTvis
qorwineba. maSasadame, qalebis umravlesoba ufro mwvaved grZnobda konfliqts
karierasa da ojaxs Soris, vidre mamakacebi
gansxvaveba damrigebelTan urTierTobebSi. Tumca iTvleba, rom damrigeblis
yola adreuli zrdasrulobis periodSi mniSvnelovania karierisTvisac da cxovrebis
mosawyobadac, qalebi aseT urTierTobebs ufro iSviaTad amyareben, vidre mamakacebi.
nawilobriv problema imaSia, rom arcTu bevri qalia xelmZRvanel poziciaze, romelTac
SeuZliaT mfarveloba gauwion axalgazrda qalebs da daexmaron maT samuSaoze. roca
qalis damrigeblis rols iRebs mamakaci, maT Soris urTierTobebi SeiZleba dairRves
"seqsualuri ltolviT maT Soris". zogjer damrigeblis rolSi gamodian qmrebi an
Seyvarebulebi, magram amas arTulebs piradi urTierTobebi. rodesac qalebi
ganamtkiceben Tavis damoukideblobas da agrZeleben muSaobas mTeli samuSao dRe an
moiTxoven Tanasworobas urTierTobebSi, qmrebi da Seyvarebulebi xSirad uars amboben
mxardaWeraze.
qalebs iseve uWirT gansakuTrebuli mamakacis povna. Tumca qmrebi da
Seyvarebulebi xSirad gamodian damxmaris rolSi, gansakuTrebiT adreuli
zrdasrulobis periodSi, roca xdeba mSoblebis gavlenisgan ganTavisufleba, axlobeli
mamakaci iSviaTad uWers mxars qalis ocnebas, Tu es safrTxes uqmnis mis upiratesobas.
amdenad, is ar asrulebs gansakuTrebuli mamakacis yvela funqcias: magaliTad, xels ar
uwyobs qalis pirovnul da profesiul zrdas.
profesiuli gzis gansxvavebebi. qalebi mamakacebze mniSvnelovnad gvian ageben
karierasac. levinsonis adreul kvlevaSi mamakacebi Segirdobis periods asrulebden 30
wliani zRvaris bolosTvis. qalebi ZiriTadad mowafeebad iTvleboden saSualo asakis
miRwevisas. im qalebis umravlesobas, romlebmac kariera daiwyes 20 wlis asakisTvis,
"Segirdobis" periodi 40 wlamde da ufro gvianac ugrZeldeboda. adamsi ikvlevda
iurist qalebs da naxa, rom isini karieras ikeTebden iseve, rogorc mamakacebi 30 wlis
gadasvlamde, magram mere maTi interesebi gadaerTveboda xolme profesiuli
warmatebebidan piradi urTierTobebisgan siamovnebis miRebaze. mamakacebisTvis kariera
rCeba ZiriTad amocanad 30 wlis Semdegac.
cxovrebiseuli miznebisa da gegmebis ganxorcielebis procesSi gansxvavebebi. 30
wlis gadasvla stresebs iwvevs mamakacebSic da qalebSic. magram msgavseba aq Tavdeba.
mamakacebma SeiZleba gamoicvalon samuSao an Secvalon cxovrebis wesi, magram ar
icvleba maTi koncentrireba samuSaoze da karieraze. qalebTan, Cveulebriv, icvleba
prioritetebi. ojaxze da gaTxovebaze orientirebuli qalebs axla moswonT profesiuli
miznebi; isini ki, vinc karieraze iyo orientirebuli, axla interesebs mimarTaven ojaxze
da qorwinebaze. amitom qalebs ufro uWirT Tavisi miznebis miRweva.
am kvlevebis Sedegebs sifrTxiliT unda movekidoT. SerCeva respodentebis iyo
Zalian mcire. da araa reprezentatuli. levinsonma gamoikvlia mxolod 10 biologi, 10
xelmZRvaneli, 10 mwerali da 10 muSa. amasTan am kvlevebSi monawile qalebis 85% da
kacebis 70% qonda umaRlesi ganaTleba. amitomac es daskvnebi aris savaraudo da
saWiroebs Semdgom ufro damajerebel kvlevebs.

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 fizikuri da kognituri ganviTareba saSualo asakSi

qronologiurad mowifulobis saSualo xana moicavs 40-dan 60-65

wlamde asaks. arsebobs azrTa sxvadasxvaoba Tu rodis iwyeba da
mTavrdeba es asaki. daoben imazec, rom cxovrebis es monakveTi zogisTvis
ufro met xans grZeldeba, zogisTvis SedarebiT mokle xans.
saSualo asaki aris Suamdebare periodi, erTgvari xidi or Taobas
Soris. am asakSi adamianebi acnobiereben rom gancalkevebuli arian
rogorc axalgazrdebisgan ("me axalgazrda aRara var"), aseve maTgan, vinc
ukve karga xania pensiaze gavida ("me jer kidev ara var moxuci").
am asakis adamianebi ukve kargad xedaven rom aqvT sul ufro meti
naoWebi saxeze, Ripi, Cndeba WaRara, zogs ki Tma aRar aqvs Tavze, da es
arc Tu sasiamovnoa. Tumca zogs metad awuxebs yovelive es, zogs ki _
naklebad.

fizikuri ganviTareba

fizikuri SesaZleblobebi Tavis ganviTarebis piks aRweven

ZiriTadad Wabukobis xanaSi da axalgazrdobaSi. saSualo asakSi ki dgeba
erTgvari platos periodi da Cndeba fizikuri SesaZleblobebis
daqveiTebis pirveli niSnebi. es niSnebi TandaTanobiT ufro TvalsaCino
xdeba. es exeba sensorikas, motorul funqciebs, aseve Sinagani
organoebisa da sistemebis funqcionirebas. Tumca es procesi Zalian
individualuria.
sensorika. mxedveloba Wabukobis xanidan TiTqmis ar icvleba 50
wlamde, Semdeg ki Tvalis simaxvile ufro swrafad iwyebs daqveiTebas.
Tumca axlomxedvelebi am periodSi xSirad ukeT xedaven, vidre
axalgazrdobaSi. smenis simaxvile iklebs 20 wlis asakidan, TandaTan
uaresdeba da saSualo asakSi ukve Wirs maRali sixSiris bgerebis aRqma.
smenis es nawilobrivi dakargva, rogorc Cans, ufro tipuria
mamakacebisTvis, vidre qalebisTvis. SesaZloa es gamowveuli iyos ufro
gare faqtorebiT (magaliTad sawarmoSi garkveuli profesiiT muSaobis
gamo), vidre daberebis bunebrivi procesiT. nebismier SemTxvevaSi smenis
daqveiTeba saSualo asakSi iSviaTad aris imdenad SesamCnevi, rom xeli
SeuSalos adamians saubarSi. gemos, ynosvis da tkivilis mgrZnobeloba

41
qveiTdeba sxvadasxva dros, Tumca ufro mdored da arc ise SesamCnevad,
rogorc smena da mxedveloba. temperaturis cvlilebebisadmi
mgrZnobeloba am asakSi isev maRalia.
senso-motoruli Cvevebi da reaqciis droc icvleba saSualo asakSi.
reaqciis drois zrda xdeba sakmaod nela da xandazmulobaSi iwyebs
aCqarebas. motorika uaresdeba, magram rezultati igive doneze rCeba _
SesaZloa didi praqtikisa da gamocdilebis Sedegad. Tumca axali
motoruli Cvevebis daufleba sul ufro Zneli xdeba.
morfo-funqcionaluri cvlilebebi. iwyeba Sinagani organoebisa da
sistemebis struqturisa da funqciebis cvlileba. neldeba, gansakuTrebiT
50 wlis Semdeg, nervuli sistemis funqcionireba. ConCxi kargavs
moqnilobas da cotaTi ikumSeba. kani da kunTebi kargaven elastiurobas,
Cndeba kanqveSa cximebis dagrovebis tendencia, gansakuTrebiT muclis
zeda nawilSi. koronaruli arteria viwrovdeba TiTqmis mesamediT.
mcirdeba filtvebis moculoba, rac iwvevs Jangbadis ukmarisobas da
adamians aRar SeuZlia ise daZabulad muSaoba, rogorc adre.
menopauza da klimaqsi. klimaqsi aris fizikuri da emociuri
gamovlinebebis farTo speqtri, romelic Tan sdevs hormonalur
cvlilebebs saSualo asakSi. qalebTan is moicavs aseve menopauzas.
menopauza qalebTan dgeba 48-51 wlis asakSi, Tumca SeiZleba daiwyos
ufro adre an gacilebiT gvian. es movlena ukavSirdeba iseT simptomebs,
rogoricaa Sexureba, oflianoba, iSviaTad Tavis tkivilebi, Tavbrusxveva,
pulsis aCqareba da saxsrebis tkivili. Tumca kvlevebis Tanaxmad
Sexureba yvelaze metad damaxasiaTebeli simptomia, radgan sxva
gamovlinebebi ufro individualuria.
hormonaluri cvlilebebi (kerZod, estrogenebis donis daqveiTeba)
iwvevs Zvlis masis cvlilebas. es orive sqesisTvis aris damaxasiaTebeli,
Tumca qalebSi menopauzis Semdeg es procesi mimdinareobs bevrad ufro
swrafad da orjer xSirad. garda amisa, qalebSi amis gamo motexilobebi
6-10-jer xSiria, vidre mamakacebSi. aris cvlilebebi emociur sferoSic.
qali am periodSi SeiZleba ganicdides daTrgunulobas, an nakleb
qalurad aRiqvamdes Tavs, radgan aRar SeuZlia bavSvis gaCena; martoxela
qalebSi SeiZleba iyos garkveuli sinanulic amis gamo. Tumca qalebis
umravlesoba ase negatiurad ar afasebs am movlenas. mamakacebSic xdeba
cvlilebebi seqsualuri aqtivobis TvalsazrisiT, magram es Zalian
individualuria. rig SemTxvevebSi Cndeba fsiqologiuri saxis
problemebi, romelTa umravlesoba SeiZleba ganpirobebuli iyos
fsiqologiuri stresiT. stresis mizezi SeiZleba iyos siZneleebi
samsaxurSi, meuRlesTan urTierTobebSi SeCveva, mravalricxovani
movaleobebi ojaxSi, an janmrTelobis problemebi.

42
 daberebasTan erTad izrdeba organizmis daavadebis SesaZleblobac.
saSualo asakis adamianebi sul ufro xSirad iwyeben fiqrs daberebisa da
sikvdilis gardauvalobaze. saSualo asakSi (daaxloebiT 44 wlis
Semdeg) adamianebi sul ufro xSirad kvdebian raime daavadebis gamo.
sikvdilianoba mamakacebSi nebismier asakSi orjer maRalia Sesabamisi
asakis qalebTan SedarebiT. mizezi SeiZleba iyos is, rom mamakacebs
muSaoba ufro saxifaTo pirobebSi uxdebaT, isini naklebad zrunaven
Tavis janmrTelobaze, ufro iSviaTad mimarTaven eqims.
yvelaze gavrcelebuli daavadebebi am asakSi aris:
• gul-sisxlZarRvTa daavadebebi
• kibo
• diabeti
• sasunTqi organoebis daavadebebi
• SidsTan dakavSirebuli daavadebebi
miuxedavad amisa, saSualo asakSi adamianebis umravlesoba mainc
sakmaod janmrTelia. swori kvebis, dozirebuli fizikuri datvirTvis da
samedicino daxmarebis regularulad miRebis Sedegad SesaZlebelia
aqtiuri cxovrebis periodis gazrda. regularuli fizikuri varjiSebi
saSualo asakamde da mis Semdeg amcireben kunTuri qsovilebis rRvevis
process da xels uwyoben cximebis dagrovebis Semcirebas. varjiSiT
SesaZlebelia saxsrebis rRvevis acileba da SeiZleba daexmaros adamians
zogierTi saxis artritebTan brZolaSi.
saSualo asakSi seriozulad iCens Tavs mavne Cvevebis Sedegebic.
yvelaze seriozulia Tambaqos moxmareba, romelic xels uwyobs
filtvebis, piris Rrus, xorxis, momnelebeli traqtis, swori nawlavis,
kuWis, kuWqveSa jirkvlis, saSvilosnos yelis, Tirkmelis, saSarde milis
da Sardis buStis kibos warmoqmnas. aseve sasunTqi organoebis, gul-
sisxlZarRvTa daavadebebis, aTerosklerozis, hipertoniis da sxva
daavadebebis Camoyalibebas.
aseve nebismieri narkotikuli nivTierebis moxmareba, maT Soris
alkoholisac, xels uwyobs qronikuli daavadebebis ganviTarebas. ziani,
romelic am mavne Cvevebis gamo adgeba RviZls da Tirkmelebs, swored
saSualo asakSi iCens Tavs.
stresi da daavadebebi. adamianebis cxovrebis stili udides
gavlenas axdens maT janmrTelobaze. stresi TamaSobs garkveul rols
saSualo asakSi bevri daavadebis ganviTarebaSi. magaliTad, varaudoben,
rom gulis daavadebebi ganpirobebulia rTuli urTierTdamokidebulebiT
iseTi faqtorebis, rogoricaa cxovrebis wesi, pirovnebis Taviseburebebi,
genetikuri midrekileba da stresi.
pirovnebis tipi. rozenmanis mier jer kidev 1974 wels Catarebul
longitudur kvlevaSi monawileobda 39-dan 59 wlamde asakis 3400
43
mamakaci. kvleva ganmeorda 2.5, 4.5 da 8.5 wlis Semdeg. mecnierebs surdaT
ganesazRvraT am adamianebis qcevis xasiaTi rogor gavlenas iqoniebda
gulis daavadebaTa sixSireze. cdispirebi pirovnuli Tvisebebis mixedviT
daiyo sam jgufad. erT polusze aRmoCnden A tipis pirovnebebi. maT
axasiaTebT mousvenroba, miRwevaze da Sejibrze orientireba,
agresiuloba; isini xSirad avlenen aramegobrul damokidebulebas,
gamoirCevian mouTmenlobiT da yovelTvis mzad arian aqtiuri
moqmedebisTvis. garda amisa, saxis nakvTebi xSirad daZabuli aqvT,
laparakoben xmamaRla, gaRizianebiT da gamudmebiT ar yofniT dro.
sapirispiro polusze aRmoCnden B tipis adamianebi. isini ar arian
agresiulebi, daZabuli, arian ufro momTmeni da megobruli. danarCenebi
ganlagden am or poluss Soris. sxvaoba am or tips Soris yovelTvis
SesamCnevi ar aris. maTi qceva gansxvavdeba ZiriTadad situaciebSi, sadac
misi unarebis (gansakuTrebiT inteleqtualuris) gamovlenaa saWiro an
konkurentuli brZolis situaciebSi. aseTi gamokveTili tipi rozenmanis
kvlevaSi cdispirebis daaxloebiT 10%-ia.
kvlevis dawyebisas arcerTs ar hqonda gul-sisxlZarRvTa daavadeba.
SemdgomSi aRmoCnda, rom A tipis warmomadgenlebs orjer ufro xSirad
uviTardebodaT koronaruli sisxlZarRvebis paTologia da orjer ufro
xSirad emarTebodaT gulis Setevebi letaluri dasasruliT.
mkvlevarebma daadgines, rom A tipis adamianTa da gulis qronikuli
daavadebebis mqone adamianebis organizmis biologiuri Tvisebebi Zalian
msgavsia. A tipis warmomadgenlebs aqvT ufro maRali qolesterini,
sisxlis Sededebis maRali maCvenebeli da muSaobis dros sisxlSi
stresis hormonebis maRali done B tipis mamakacebTan SedarebiT. B tipis
cdispirebs iSviaTad uCndebodaT sisxlZarRvTa daavadeba 70 wlis
asakamde, damoukideblad imisagan moixmarden Tu ara cximian sakvebs,
bevrs eweoden an fizikur varjiSebs asrulebden Tu ara.
Tumca mxedvelobaSi unda miviRoT is garemoeba, rom mamakacebis
90% moxvda am or poluss Soris da rom zogierTs aseve gauCnda
koronaruli problemebi. garda amisa, yvela mkvlevari ver naxulobs aseT
mWidro kavSirs A an B tipisadmi mikuTvnebulobasa da gulis daavadebebs
Soris. amasTan, A tipis pirovnebis yvela Tviseba ar aris dakavSirebuli
aseT daavadebebTan. gulis daavadebebTan ufro iseTi Tvisebebi unda iyos
dakavSirebuli, rogoricaa agresiuloba da swrafva gaimarjvo nebismier
safasurad. Tumca stereotipuli warmodgena, rom maT, vinc dRedaRam sul
muSaoben ("Sromagolikebi") axasiaTebT gulis Setevebi, mcdari unda iyos.
sainteresoa isic, rom sxva pirovnuli Tavisebureba, kerZod,
depresiisadmi midrekileba, aseve dakavSirebulia gulis daavadebis
riskTan. rigma kvlevebma aCvena, rom depresia ufro Zlieri prognostuli
parametria vidre A tipis pirovnebis dadgena. nakleb aris gamoxatuli
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kavSiri gulis daavadebebsa da iseT TvisebebTan rogoricaa
aramegobruloba, gaRizianebadoba da SfoTva.
distresi. stresis rogori saxeebia saSiSi janmrTelobisTvis?
saSualo asakSi Sesvla TavisTavad xom ar aris stresi? es xom is
periodia, roca unda gadaxedo miznebs, Seeguo ojaxSi rolebis cvlas,
dauTmo adgili ufro axalgazrdebs an biologiuri daberebis pirvel
niSnebs gaumklavde.
adamianis cxovrebaSi bevri mniSvnelovani da stresuli ram xdeba.
Caatares gamokiTxva, cdispirebs Txoves 100 quliT SeefasebinaT
sxvadasxva cxovrebiseuli movlena _ ra situaciebi da movlenebi aris
yvelaze stresuli. aRmoCnda, rom meuRlis dakargva umravlesobis azriT,
aris yvelaze mZime movlena cxovrebaSi (100 qula). xolo racionis
Secvlis aucilebloba da dietis dacva arc ise Znelia da mxolod 15
quliT iqna Sefasebuli umravlesobis mier. ramdenadac saSualo asaki
swored is droa, rodesac adamianebi kargaven meuRles gardacvalebis an
ganqorwinebis gamo, maT cxovrebaSi xdeba usiamovno rameebi, magaliTad
pensiaze adre gasvla an avadmyofoba. Zneli araa imis mixvedra, rom es
periodi stresis ganviTarebis TvalsazrisiT friad maRali potencialiT
gamoirCeva. magram stress iwveven ara TavisTavad cxovrebiseuli
garemoebebi, aramed is Tu ra mniSvnelobas aniWebs adamiani ama Tu im
movlenas _ erTidaigive movlena zogisTvis advilad gadasatania, zogi ki
distresSi vardeba.
periodulad stresogenul movlenebTan Sejaxeba SeiZleba gaxdes
pirovnuli ganviTarebis stimuli. Tu adamianSi raime movlenis molodini
arsebobs an icis rom moxdeba, aman SeiZleba naklebi stresi gamoiwvios,
vidre moulodnelad rom moxdeba maSin. amasTan, romelime erTi
stresori SeiZleba damokidebuli iyos sxva problemebze, romelic
awuxebs adamians mocemul momentSi (fulis arqona, iuridiuli saxis
problemebi, ojaxSi usiamovnebebi). aseve imaze, Tu ra xarisxiT aisaxeba
usiamovno movlena cxovrebis Cveul ritmze da ramdenad emuqreba es
movlena adamianis pirad keTildReobas. lazarusi Tvlis, rom
mravalricxovani wvrilmani yoveldRiuri sazrunavi da problemebi
zogjer qmnian ufro stresogenul situacias, vidre romeliRac
mniSvnelovani movlenebi cxovrebaSi.
stresis zemoqmedebis gazrda an Semcireba SeuZlia imas, Tu
konkretuli adamiani rogor cdilobs masTan gamklavebas. bevri Tvlis,
rom is adamianebi, romlebic akaveben Tavis risxvas, pirvel rigSi
xvdebian stresis Sedegad somaturi daavadebebis riskis qveS. Tumca es
mosazreba sulac ar aris udao. A tipis adamianis qcevis Seswavlisas
aRmoCnda, rom ukiduresad daZabuli adamianebi xSirad "amoafrqveven"
xolme Tavis gaRizianebas da ganitvirTebian. Tumca calkeul

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SemTxvevebSi es kidev ufro met gaRizianebas iwvevs da SesaZloa am
adamianebs xSirad daemarToT gulis Setevebi.

kognituri unarebis ganviTareba

longitudurma kvlevebma aCvena, rom asakTan erTad adamianis
kognituri funqcia qveiTdeba. magram es procesi mimdinareobs gacilebiT
nela, vidre amas varaudobden mecnierebi 30 wlis win.
erT-erTi Teoriis mixedviT arsebobs 2 tipis inteleqti. erTia
mdinari inteleqti. es is unarebia romelTa daxmarebiTac Cven raime
axals vswavlobT; esaa siswrafe da produqtuloba daxsomebisas,
induqciuri msjeloba, sivrciTi xatebiT operireba da axali kavSirebisa
da mimarTebebis aRqma. termini mimdinare inteleqti gulisxmobs, rom es
bazisuri procesebi erTiandeba sxva mravali saxis inteleqtualur
moqmedebebSi aRqmis, cnobis mexsierebis, analizisa da sxvadasxva
amocanebis gadawyvetis CaTvliT. iTvleba, rom mimdinare inteleqtis
ganviTareba grZeldeba Wabukobis xanamde, Semdeg ki xdeba misi
TandaTanobiT daqveiTeba mowifulobisa da xandazmulobis periodSi.
kristalizebuli inteleqti aris unari, romelic modis
gamocdilebasTan erTad da emyareba xangrZlivi drois ganmavlobaSi
dagrovil codnas. es aris unari daamyaro mimarTebebi, Camoayalibo
msjeloba, gaaanalizo problemebi da gamoiyeno aTvisebuli strategiebi
konkretuli amocanebis gadasawyvetad. iTvleba, rom zogierTi saxis
testebi (magaliTad, testebi verbaluri azrovnebis, leqsikuri maragis,
socialuri moTxovnebis gagebis) zomaven ZiriTadad kristalizebul
inteleqts. mimdinare inteleqtisgan gansxvavebiT kristalizebuli
inteleqti cxovrebis manZilze xSirad matulobs. longitudur kvlevebSi
am testebiT roca izomeba inteleqti, adamianebs xSirad 50 wlis asakSi
ufro maRali Sedegebi aqvT, vidre 20 wlis asakSi hqondaT. amiT SeiZleba
aixsnas, rom mecnierebi, visi samuSaoc dagrovil codnasa da
gamocdilebas emyareba, rogorc wesi, gamoirCevian maRali
produqtulobiT 40, 50 da 70 wlis asakSic ki, da ara axalgazrdobisas.
riT gansxvavdebian "eqspertebi" 'axalbedebisagan"? upirveles
yovlisa imiT, rom eqspertebs aqvT didi codna rogorc deklaratiuli
(faqtebis codna), aseve proceduruli (xerxebis codna). ufro metic, es
codna maT ukeT aqvT organizebuli. "eqspertebi" ufro swrafad da
zustad amoicnoben tipur amocanebs da pouloben maTTvis Sesabamis
gadawyvetis xerxebs. es exeba nebismieri sferos eqspertebs _ fizikiT da
programirebiT dawyebuli da astrologiiT damTavrebuli.
marTalia eqspertebi ukeT inaxaven mexsierebaSi mTavar informacias,
magram roca WirdebaT iseTi masalis gaxseneba, romelic araa mibmuli

46
konkretuli amocanis gadawyvetasTan, amas "axalbedebze" ukeT ver
akeTeben. kvlevebma aCvena, rom xnieri moWadrakeebi ver ixsenebden yvela
figuris ganlagebas dafaze, asakovani mbeWdavi qalebi furclidan
beWdaven ufro nela, xanSi Sesuli arqiteqtori asakTan erTad kargavs
sivrciTi mimarTebebis Sefasebis unar-Cvevas da sxv. magram gamocdileba
axdens kompensirebas. gamocdili memanqane qali met sityvebs ixsomebs
erTi SexedviT da amis Sedegad izrdeba misi muSaobis siswrafe.
saSualo asakis adamianTa umravlesobisTvis kognituri unarebis
ganviTarebis garemo aris samsaxuri. adamianebi, romelTa profesiuli
saqmianoba gamoirCeva sirTuliT da mravaplanianobiT, gonebrivi unarebis
moqnilobaze testebSi ukeTes rezultats aCveneben, vidre isini, visi
samuSaoc ufro rutinuli xasiaTisaa. swrafad cvalebadi teqnologiebis
epoqaSi adamianebs, romelTac axali codnis SeZenisTvis saWiro
kognituri unar-Cvevebi aqvT ganviTarebuli, ufro advilad SeuZliaT
Segueba Sromis axal pirobebTan. es unari gansakuTrebiT mniSvnelovania
saqmianobis im sferoebSi, sadac swrafad xdeba profesiuli codnis
daZveleba. magaliTad medicinaSi, kompiuterul programirebaSi da
teqnikur konstruirebaSi. codnis daZvelebis problema gansakuTrebiT
aqtualuria saSualo asakis adamianebisaTvis.
Saies azriT, droSi cvlilebebs ganicdis inteleqtis funqcia da
ara misi buneba. saSualo asakSi adamianebi imyofebian socialuri
movaleobebis Sesrulebis stadiaze Saies periodizaciis mixedviT. Tu
adreuli mowifulobis periodSi (miRwevebis stadia) inteleqti
gamoiyeneboda iseTi problemebis gadasawyvetad rogoricaa meuRlis an
samuSaos arCeva (anu piradi problemebis gadasawyetad). saSualo asakSi
gadawyvetilebis miRebisas uxdebaT sxva adamianis (meuRle, Svilebi,
kolegebi) mosazrebebis gaTvaliswineba _ saSualo asakSi adamiani
inteleqts iyenebs sxvebis problemebis mosagvareblad.

fsiqo-socialuri ganviTareba saSualo asakSi

47
saSualo asakis amocanebi

karl iungma erT-erTma pirvelma miaqcia seriozuli yuradReba adamianis

cxovrebis meore naxevars, magram arc ise didi xania rac fsiqologebma aRiares,
rom mozrdili adamianebic viTardebian. aman ganapiroba longituduri kvlevebis
simcire. Tumca aris saintereso kvlevebic. magaliTad, heivigherstis (1953)
modeli zrdasruli adamianis ganviTarebis.

am modelis Tanaxmad mowifulobis adreul periodSi adamianis winaSe

dgeba Semdegi amocanebi:

• meuRlis arCeva
• mzadeba ojaxis Sesaqmnelad
• ojaxis Seqmna
• Svilebis aRzrda
• saSinao saqmeebis warmoeba
• profesiuli saqmianobis dawyeba
• samoqalaqo pasuxismgeblobis aReba
• misaRebi socialuri jgufis moZebna

rac Seexeba saSualo asaks, aq adamianma ukve sxva amocanebi unda

gadawyvitos:

• samoqalaqo da socialuri pasuxismgeblobis miRweva

• sasurveli cxovrebis donis miRweva da SenarCuneba
• Tavisufali drois gatarebis misTvis sasurveli xerxebis arCeva
• Svilebis daxmareba
• meuRlesTan piradi urTierTobebis ganmtkiceba
• fiziologiuri cvlilebebis miReba da amasTan Segueba
• moxucebul mSoblebTan urTierTobasTan Segueba

1990-ian wlebSi am amocanebs daemata:

• martoxela cxovrebis awyoba an dagvianebiT ojaxis Seqmna da patara

bavSvebis aRzrda
• axali meuRlis arCeva ganqorwinebis Semdeg da axal cxovrebasTan Segueba
• axali profesiis aTviseba an vadamde pensiaze gasvlis problemis mogvareba

48
mamakacebi cxovrebis Sua xanSi

farrelma da rozenbergma ikvlies rogor reagireben mamakacebi cxovrebis

Sua xanis miRwevaze, ganicdian Tu ara distress, aris Tu ara es krizisuli
periodi mamakacis ganviTarebaSi. maT 300 Sua xnis mamakacis interviu
gaaanalizes da Seadares axalgazrda mamakacebis monacemebs. ekiTxeboden
ojaxze, samsaxurze, fizikur monacemebze. maTi azriT, yoveli adamiani TamaSobs
aqtiur rols imaSi Tu rogor aewyoba misi cxovreba. mamakacebis umravlesoba
grZnobda pasuxismgeblobas rogorc samuSaos, aseve ojaxis mimarT. maT
umravlesobas hqonda Camoyalibebuli cxovrebis stili, romelic exmareboda
problemebis mogvarebaSi. bevri respodenti erTnair problemebs xvdeboda:
moxuc mSoblebze zrunva, mozard SvilebTan siZneleebi, SeCveva asakiT
ganpirobebul SezRudvebTan.

tradiciulad iTvleboda, rom Sua xnis mamakacis fsiqologiuri

keTildReoba dakavSirebulia mxolod mis profesiul rolTan, Tumca kvlevebma
aCvena, rom "is, Tu rogor gadaitans adamiani Sua xnis periods Zalian aris
damokidebuli kulturaze da misi ojaxis struqturaze".

es mecnierebi Tvlian, rom arsebobs saSualo asakSi ganviTarebis 4 gza:

1. generatiuli mamakaci. mas ar aqvs Sua xnis krizisi, radgan moaxerxa

adeqvaturad gadaeWra cxovrebiseuli problemebis umetesoba. aseTi
mamakacisTvis cxovrebis Sua xani SeiZleba iyos Tavisi SesaZleblobebisa
da dasaxuli miznebis miRwevis periodi.
2. fsevdo-ganviTarebuli mamakaci. aseTi mamakaci umklavdeba problemebs
imiT, rom Tavs aCvenebs, TiTqos yvelaferi akmayofilebs an rom
yvelafers akontrolebs. sinamdvileSi grZnobs, rom CixSia an rom
yvelaferi Zalian mobezrda.
3. cxovrebis Sua xanis krizisSi myofi mamakaci. aseTi mamakaci dabneulia
da eCveneba, rom misi samyaro ingreva. mas ar SeuZlia daakmayofilos mis
mimarT wayenebuli moTxovnebi da gadawyvitos problemebi.
zogierTisTvis es krizisi SeiZleba iyos ganviTarebis droebiTi faza,
sxvebisTvis ki SeiZleba gaxdes dasawyisi daRmasvlis.
4. bedisgan daCagruli mamakaci. aseTi mamakaci SeiZleba iyos ubeduri da
uaryofili umeteswilad Tavis cxovrebaSi da avlens Sua xnis kriziss.
Cveulebriv mas ar SeuZlia problemebTan gamklaveba.
es mkvlevarebi Sua xnis krizisis mizezs xedaven imaSi, rom dasavlur
sazogadoebaSi arsebobs warmatebuli mamakacis xati da mamakacebis umravlesoba
cdilobs iyos am xatis Sesatyvisi. Sua xnis asakSi mamakacebs mTeli rigi
problemebi uCndebaT swored imis gamo, rom uxdebaT imis gacnobiereba, rom ver
akmayofileben am moTxovnas. cota vinme Tu axerxebs aicilos warumateblobis,
TviTpativiscemis dakargvis gancda.

49
qalebi cxovrebis Sua xanSi

cxovrebis Sua xani xSirad qalebisTvisac aris gardamavali periodi,

rodesac xdeba bevri ramis gadafaseba. tradiciulad qalebi moiazreben Tavis
Tavs ufro ojaxis ciklSi, vidre profesiul ciklSi. am asakis samsaxurSi
dakavebul qalebs saerTo aqvT is, rom uWirT gamonaxon dro ojaxisTvisac da
samsaxurisTvisac. magaliTad, xelmZRvanel poziciaze momuSave qals ar aqvs
dro yovel saRamos sadilis mosamzadeblad. ase Cndeba roluri konfliqtebi.
Tumca aris SemTxvevebi, roca ar aris roluri konfliqti (radgan qali,
magaliTad, diasaxlisia da erTi roli aqvs miRebuli), magram SeiZleba iyos
roluri daZabuloba, roca mas am rolSi Zalian bevri pasuxismgebloba akisria
(deda, romelic cdilobs samive bavSvs saTanado yuradReba dauTmos, SeiZleba
grZnobdes daZabulobas, rom ar gamosdis es).

qalebi mamakacebze metad reagireben fizikur daberebaze. amitom araa

gasakviri, rom kvlevebis mixedviT didia depresiis sixSire Sua xnis qalebSi
sxva asakis qalebTan SedarebiT amis gamo.

interpersonaluri urTierTobebi

Sua xnis adamianebi TamaSoben Sualeduri rgolis rols umcros Taobasa

(Tavis Svilebsa) da ufros Taobas (Tavis mSoblebs) Soris. axla isini
warmoadgenen Taobas, romelmac unda aiRos ZiriTad gadawyvetilebebze
pasuxismgebloba. es axali pasuxismgebloba aiZulebs am adamianebs Seajamon,
garkveuli TvalsazrisiT, ukve ganvlili gza da miRwevebi. SeiZleba guli
wydebodeT, rom raRac miznebi ver ganaxorcieles, raRac dausrulebeli darCaT,
garkveuli gegmebi ki aseve darCeba gegmad. saSualo asakis adamianebi cxovroben
awmyo droSi ufro metad, vidre sxva asakobrivi jgufebis warmomadgenlebi.
axalgazrdebi momavlisken iyurebian, moxucebi _ warsulisken, Sua xnis
adamianebi ki cxovroben "aq-da-axla". axla maT evalebaT ojaxisa da
tradiciebis dacva, miRwevebis aRniSvna, ojaxis istoriis Senaxva, ojaxis
Sekreba dResaswaulebze, ojaxis wevrebis daxmareba da sxv.

SvilebTan damokidebuleba

Sua xnis adamianebs Svilebi ukve wamozrdili hyavT da dgeba maTi

damoukidebel cxovrebaSi gaSvebis da maTgan moSorebiT cxovrebasTan Seguebis
periodi.

zogi ojaxi kargad arTmevs Tavs am process. axalgzrdebis mxardaWeras

yvelaze ukeT axerxeben is mSoblebi, romlebsac mudam aqvT urTierToba
50
SvilebTan, da Tan metad endobian da pativs scemen maT gadawyvetilebebs da
mosazrebebs. mSoblebma unda iswavlon SvilebisTvis gonivruli Tavisuflebis
micema da unda miiRon Svilebi iseTebi, rogoric arian sinamdvileSi.

es procesi mSoblebisTvisac axal mdgomareobaSi gadasvlaa. mSoblebi

xSirad amboben, rom marTalia isini moxarulebi arian rom Svilebi hyavT,
Svilebis saxlidan wasvlis Semdeg dgeba sakmaod sasiamovno periodi maT
cxovrebaSi, radgan aqvT meti Tavisufali dro, meti SesaZleblobebi
TviTrealizaciisTvis. qalebi gansakuTrebiT mogebuli arian am mdgomareobiT,
radgan mcirdeba maTi yoveldRiuri valdebulebebi, metad SeuZliaT sakuTari
gatacebis da interesebis realizeba.

rodesac Svilebi qorwindebian, mSoblebi uceb aRmoCndebian sruliad

ucxo adamianTan urTierTobis da masTan Seguebis aucileblobis winaSe. esec
erT-erTi mniSvnelovani amocanaa am asakSi.

migraciuli procesebi (Svilebis gamgzavreba saswavleblad an samuSaod)

gansakuTrebiT aCens "dacarielebuli budis" gancdas.

saSualo asakisTvis urTierTobebi mSoblebsa da Svilebs Soris xdeba

ufro ormxrivi da Tanaswori, vidre adre. es urTierTobebi kargavs ierarqiul
xasiaTs. Tanaswor urTierTobebze gadasvla iSviaTad xdeba advilad da uceb.
Cveulebriv es xdeba naxtomebiT ramdenime wlis ganmavlobaSi. iqneba es procesi,
ufro martivi Tu rTuli, damokidebulia imaze, rogori iyo mSoblebis
damokidebuleba Svilebisadmi. Tu es iyo avtoritaruli urTierToba, axali
rolebi da valdebulebebi ufro xSirad aris formaluri, rigiduli da Znelad
Tu icvleba. aseT SemTxvevaSi Sua xnis mSoblebi da maTi ukve gazrdili
Svilebi zogjer wlebis manZilze ibrZvian Tanaswori urTierTobebis
Sesaqmnelad.

Svilebi xSirad grZnoben gamoyofis, damoukideblad cxovrebis

aucileblobas, droebiT mainc, manamde sanam SesZleben realisturad Sexedon
Tavis mSoblebs. roca es xdeba, Sua xnis mSoblebi SeiZleba grZnobden rom
Svilebi maT iSoreben an aRar afaseben. xSirad swored ojaxuri krizisis dros
(gardacvaleba an avadmyofoba ojaxis wevris, finansuri problemebi,
ganqorwineba an samuSaos dakargva) ukve zrdasruli Svilebi da maTi mSoblebi
gamonaxaven xolme gzas Tavisi urTierTobebis ise mosagvareblad, rom
SemdgomSi ukve SeuZliaT erTmaneTis mxardaWerisa da daxmarebis imedi hqondeT.
zog ojaxSi es procesi grZeldeba 20-dan 40 wlamde, sxvebSi ki interesebis
urTierTpativiscema Cndeba rogorc ki bavSvebi miaRweven Wabukobis asaks.
Cveulebriv, urTierTobebi mSoblebsa da Svilebs Soris Sua xnis periodSi
umjobesdeba da sabolood ukve Svilebi iReben Taobebs Soris SemaerTebeli
rgolis rols Tavis Tavze.

damokidebuleba moxuci mSoblebisadmi

51
 saSualo asakis adamianebi unda Seeguon Tavisi moxuci mSoblebis
moTxovnilebebsa da Secvlil rolebs. roca mSoblebs kargi janmrTeloba aqvT,
da SeuZliaT damoukideblad cxovreba, maTi urTierTobebi mSoblebTan xSirad
aris Tanaswori. rac niSnavs, rom mSoblebi da maTi zrdasruli Svilebi
konkretulad exmarebian erTmaneTs. aseTi urTierTobebi, Cveulebriv, icvleba
maSin, rodesac mSobeli avad xdeba an Zalian sustdeba imisaTvis, rom
damoukideblad icxovros. moxuci mSoblebisa da maTi ukve saSualo asaks
miRweuli Svilebis urTierTobaze xSirad gavlenas axdens sqesis faqtori.
qaliSvilebi gansxvavdebian vaJiSvilebisagan. mniSvneloba aqvs imasac moxuc
mamazea laparaki Tu dedaze.

saSualo asakis adamianebis umravlesobas mudmivi kavSiri aqvs Tavis

moxuc mSoblebTan. amaSi igulisxmeba regularuli urTierToba, saerTo
mogonebebi, urTierTdaxmareba. moxuc mSoblebsa da maT Svilebs Soris
gamudmebiT xdeba socialuri, materialuri da emociuri xasiaTis urTierToba.
bevri xanSiSesuli mSobeli exmareba finansurad Svilebs da SviliSvilebs.
SedarebiT Rarib ojaxebSi mSoblebs ar aqvT finansuri resursebi, magram aseT
SemTxvevaSi ufro xSirad mxardaWera aris socialuri. magaliTad,
SviliSvilebis movla.

mSoblebis daberebis Sesabamisad saSualo da ufros Taobas Soris xdeba

rolebis Secvla. ufrosi Taobis warmomadgenlebi SeiZleba iyon ukve pensiaze,
hqondeT cudi janmrTeloba, SeiZleba sWirdebodeT finansuri daxmareba an sxva
TvalsazrisiT iyon damokidebuli Svilebze. amitom Zalaufleba TandaTan
garkveuli xnis ganmavlobaSi gadadis maTi saSualo asakis Svilebze. Tu orive
Taoba ar gaacnobierebs, rom rolebis aseTi Secvla aris aucilebeli nawili
cxovrebis, SeiZleba aman gamoiwvios wyena da aRSfoTeba orive mxareSi.

qaliSvilebi bevrad ufro xSirad uvlian moxuc mSoblebs, vidre

vaJiSvilebi. aris sxvaoba samsaxurSi dakavebul qalebsa da diasaxlisebs Soris
mSoblebis movlasTan dakavSirebiT. mosamsaxure qaliSvilebi emociur
mxardaWerasTan erTad mSoblebs daxmarebas uweven iseT saqmeebSi, rogoricaa
sayidlebi, gadazidva, wayvana da es igive moculobiT xdeba, rogorc diasaxlis
qaliSvilebTan. Tumca diasaxlisi qaliSvilebi ufro xSirad exmarebian
mSoblebs saWmlis momzadebaSi da pirad movlisas. mosamsaxure qaliSvilebis
mniSvnelovani nawili mzadaa Secvalos samuSao reJimi, roca es mSobels
Wirdeba (20-30 %). sazogadod, moxuc mSoblebze zrunva aris sixSiris mixedviT
meore mizezi, romelic aiZulebs saSualo asakis qalebs datovon samuSao
(pirveli mizezia sakuTari janmrTelobis problemebi). Zmebs da debs SeuZliaT
erTad daexmaron avadmyof mSoblebs. Tumca maT Soris Sromis ganawileba
yovelTvis Tanasworad ar xdeba. qaliSvilebi exmarebian ufro xSirad, vidre
vaJiSvilebi. faqtiurad, mSoblebic qaliSvilebisgan ufro met daxmarebas
moelian, vidre vaJiSvilebisgan. Tu mSobels hyavs ori qaliSvili romelTaganac
erTi muSaobs, maSin meore, romelic ar muSaobs, metad exmareba yoveldRiurad.
aseve saswrafo daxmarebas uwevs kritikul situaciebSi.

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 mSoblebis movlis movaleobas moaqvs aramarto kmayofilebis grZnoba. es
SeiZleba stresis wyaroc iyos. qaliSvilebi did Zalebs deben mSoblebis
movlaSi da SeiZleba aman gamoiwvios gadaRla. garda amisa, zogierTSi es iwvevs
dapirispirebas am movaleobebis Sesrulebaze damokidebulebasa da
damoukideblobas Soris. SeiZleba kvlav gaRvivdes Zveli konfliqtebi an sxva
ojaxuri problemebi mSoblebsa da Svils an ded-mamiSvilebs Soris. amas garda,
mSoblebis movla SeiZleba iyos sakuTari momavalis ukeT gacnobierebac, rom
masac SeiZleba dasWirdes aseTi movla Tavis droze. am Sinaganma konfliqtebma
droisa da Tavisuflebis TvalsazrisiT realurad arsebul sirTuleebTan
erTad, SeiZleba Seqmnas stresuli viTareba. aRsaniSnavia, rom miuxedavad amisa,
saSualo asakis adamianebis 80-90% uvlis moxuc mSoblebs. zogierTi qali
praqtikulad gamudmebiT uvlis da zrunavs xan erT, xan meore moxuc naTesavs.
miuxedavad avadmyof moxucebze aseTi didi zrunvisa, erT-erTi gamokiTxvis
Sedegad gamovlinda, rom daaxloebiT 60% saSualo asakis qalebis, romlebic
uvlian moxucebs, "ratomRac damnaSaved grZnobden Tavs, rom cota ram gaakeTes
dedebisTvis da maTi 75% eTanxmeba mosazrebas, rom Cvens droSi Svilebi arc
ise kargad zrunaven Tavis moxuc mSoblebze, rogorc es adre iyo".

SviliSvilebis movla

bevri saSualo asakis adamiani aRmoCndeba xolme bebiebisa da babuebis

rolSi. umravlesobisTvis es didi kmayofilebis momtania. isini dakavebuli
arian axali Taobis aRzrdiT, Tumca ar aqvT iseTi pasuxismgebloba, rogorc
manamde.

SviliSvilebis aRzrda Zalian individualuria. ar arsebobs erTi

zogadad miRebuli xerxi, romelsac iyeneben bebiebi da babuebi ojaxSi an
Tundac amaTuim kulturaSi. Tumca arsebobs garkveuli rolebi, romelsac isini
asruleben imis mixedviT Tu rogori damokidebuleba aqvT SviliSvilebTan. Tu
deda marto zrdis bavSvs an Tu orive mSobeli muSaobs, dRis didi nawilis
ganmavlobaSi bebiebi da babuebi SeiZleba zrunavden bavSvebze. zogierTs miyavs
SviliSvilebi maRaziaSi, saseirnod, saintereso adgilebSi (muzeumi, zooparki
da sxv.).

bengenstonma gamoyo 4 mniSvnelovani roli, romelsac asruleben bebiebi

da babuebi:

1. arseboba. maTi ubralod arsebobac ki damamSvideblad moqmedebs roca

raime seriozuli konfliqti an problema Cndeba ojaxSi. bebiebi da
babuebi warmoadgenen garkveul simbolos stabilurobis rogorc
SviliSvilebis, ise maTi mSoblebisTvis.
2. ojaxis "nacionaluri gvardia". zogierTi bebia da babua ambobs, rom maTi
mTavari funqcia aris iyon gverdiT kritikul situaciaSi. am dros isini
ubralod ki ar arseboben, aramed aqtiurad erTvebian SviliSvilebis
aRzrdaSi.

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 3. arbitrebi. zogierTi bebia da babua xedavs Tavis rols imaSi, rom ataros
ojaxuri faseulobebi, ojaxis mTlianobas dauWiros mxari, konfliqtebis
dros daexmaros TaobaTa Soris kavSirebis SenarCunebas. marTalia
sxvadasxva Taobas xSirad gansxvavebuli faseulobebi aqvs, zogierTi
bebia da babua Tvlis, rom maT ufro advilad SeuZliaT SviliSvilebsa
da maT mSoblebs Soris arsebuli konfliqtebis daregulireba, radgan
aqvT meti gamocdileba da SeuZliaT Sexedon konfliqts gareSes TvaliT.
4. ojaxuri istoriis Senaxva. farTo gagebiT bebiebs da babuebs SeuZliaT
Seqmnan ojaxis mTlianobis da memkvidreobiTobis gancda. gadascemen ra
ojaxur tradiciebs da memkvidreobas.
zogjer ojaxuri faseulobebi gadaecema ara bebiebis da babuebis
pirdapiri CareviT, aramed ufro imiT, rom SviliSvilebi da maTi mSoblebi
iTvaliswineben maT SesaZlo reaqciebs. magaliTad, SviliSvili SeiZleba ar
gaTxovdes sxva socialuri an eTnikuri an religiuri jgufis warmomadgenelze,
radgan icis, rom bebiam an babuam SeiZleba uaryofiTad miiRon es.

megobruli urTierTobebi

saSualo asakSi, rodesac mniSvnelovnad icvleba ojaxuri urTierTobebi,

bevri sayrdens poulobs ufro megobrebSi, vidre ojaxis wevrebTan. miuxedavad
imisa, rom adamianTa umravlesoba qorwindeba da ojaxs qmnis, sul ufro metia
raodenoba im adamianebis, romlebic irCeven martoxela cxovrebas, an marto
zrdian Svils. maTTvis megobrebi gansakuTrebiT mniSvnelovan rols asruleben.
loventalma gamokiTxa sxvadasxva asakis adamianebi (ufrosklaselebi,
axaldaqorwinebulebi, saSualo asakis adamianebi). saSualo asakis adamianebis
umravlesoba aRniSnavda, rom maT hyavT ramdenime axlo megobari, romlebTanac
megobroben aranakleb 6 wlisa, xolo skolis moswavleebs da
axaldaqorwinebulebs ufro cota dro akavSirebda megobrebTan. respodentebs
ekiTxeboden ra Tvisebebia mniSvnelovani realuri megobrobisas da ra Tvisebebi
unda axasiaTebdes idealur megobars. yvela asakis respodenti daaxloebiT
erTnairad uyurebda am sakiTxs. idealuri megobris yvelaze mniSvnelovan
Tvisebad Tvliden urTierTdaxmarebas da TanagrZnobas. ambobden, rom maTi
megobrebi bevr rameSi gvanan maT. genderuli sxvaobebi ufro gamoikveTa, vidre
asakobrivi. qalebi ufro dawvrilebiT pasuxobden, vidre mamakacebi da iqmneboda
STabeWdileba, rom isini ufro Rrmad arian CarTuli megobrul urTierTobebSi.
qalebi urTierTgagebas Tvliden yvelaze mniSvnelovan Tvisebad rogorc
realuri, ise idealuri megobrebisTvis, mamakacebi ki irCevden megobrebs ufro
msgavsi cxovrebiseuli gamocdilebis, interesebis, Sexedulebebis da codnis
mixedviT. saSualo asakis dasawyisSi adamianebi ufro arian dakavebuli ojaxiT
da karieris ganmtkicebiT. maT naklebi dro rCebaT megobrebisTvis. magram
saSualo asakis bolosTvis yalibdeba rTuli da mravalplaniani urTierTobebi
megobrebTan. am etapze adamianebi metad afaseben Tavisi megobrebis
individualobas, ganumeorebel Tvisebebs.

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 ganqorwineba da ganmeorebiTi qorwineba

Cvens droSi ojaxebi xSirad ver Tavsdebian ojaxis tradiciul modelSi

_ momuSave mama, diasaxlisi deda da ori Svili. warmodgenebi ojaxze icvleba
misi wevrebis socialuri da piradi moTxovnilebebisa da prioritetebis
mixedviT. yvelaze mniSvnelovani faqtorebi, romlebic gavlenas axdenen ojaxze,
aris ganqorwineba, meored qorwineba da ojaxis Seqmna gerebTan erTad.

rogorc wesi, ganqorwineba xdeba ojaxuri cxovrebis pirveli 7 wlis

ganmavlobaSi, da ojaxuri cxovrebis saSualo xangrZlivoba ganqorwinebuli
wyvilebisTvis aris 7,2 weli. miuxedavad imisa, rom ganqorwineba SesaZlebelia
nebismier asakSi, axalgazrdebi ufro xSirad ganqorwindebian, vidre saSualo
asakis adamianebi.

ganqorwinebis mizezebi. colqmruli urTierTobebis gauareseba iSviaTad

xdeba ucbad. xSirad es aris meuRleebis emociurad daSorebis an maTi
daukmayofileblobis da erTmaneTisgan sul ufro metad damoukideblobis
miRebis xangrZlivi procesis kulminacia. magram saboloo gadawyvetilebas
ganqorwinebis Sesaxeb iRebs erTerTi mxare da ara orive. rogorc wesi, sakiTxs
ganqorwinebis Sesaxeb svams coli. qalebi ufro xSirad da ufro metad
ganicdian daukmayofileblobas qorwinebiT, Tumca saboloo gadawyvetileba
SeiZleba maT mier ar iqnas miRebuli.

saSualo asakSi ganqorwinebis mizezebi ZiriTadad, iseTivea rac adreul

asakSi; meuRleebs surT miiRon ojaxuri cxovrebidan meti, vidre aqvT axla.
aseT SemTxvevebSi ganqorwineba ukeTesia, vidre ubeduri, konfliqtebiT da
imedgacruebiT savse Tanacxovreba. garda amisa, Tu qorwineba ar aris myari,
Svilebis mier ojaxis datovebam SeiZleba gamoiwvios krizisi. meuRleebi
acnobiereben, rom aRar aris saWiro erTad yofna Svilebis gulisTvis, da
SeiZleba dafiqrden undaT Tu ara ase gaataron mTeli darCenili cxovreba.

xSirad ganqorwineba xdeba qorwinebaze araswori warmodgenebis gamo. bevr

wyvils sjera miTebis qorwinebisa da ganmeorebiT qorwinebis Sesaxeb. miTi _ es
aris uaRresad gamartivebuli mosazreba, romelic gavlenas axdens socialur
aRqmasa da molodinebze. bernardma 1981 wels gaakeTa saintereso Sedareba 8
aseTi miTis qorwinebisa da ganqorwinebis Sesaxeb.

qorwineba

55
1. Tu erTmaneTi gviyvars, yvelaferi mogvardeba;
2. yovelTvis ifiqre jer sxvaze;
3. xazi gausvi dadebiT mxareebs; kritika SenTvis Seinaxe;
4. Tu raRac ise ar aris, yuradReba gadaitane momavalze (ifiqre momavalze);
5. sakuTari Tavi ganixile upirveles yovlisa rogors wyvilis elementi,
mxolod amis Semdeg rogorc individi;
6. yvelaferi Cemi _ Senia;
7. qorwineba adamianebs xdis ufro bedniers, vidre iyvnen manamde;
8. rac kargia Cveni SvilebisaTvis, is kargia CvenTvisac.

ganqorwineba

1. radgan erTmaneTi aRar gviyvars, veRarafers izam;

2. yovelTvis upirvelesad ifiqre sakuTar Tavze;
3. xazi gausvi uaryofiTs da akritike yvelaferi;
4. Tu rame ar gamodis, yuradReba gadaitane warsulze;
5. ganixile sakuTari Tavi upirveles yovlisa rogors individi da amis Semdeg
rogorc wyvilis wevri;
6. yvelaferi Seni _ Cemia;
7. ganqorwineba adamianebs xdis ubedurs;
8. is, rac kargia CvenTvis, damangrevelia Cveni bavSvebisaTvis.

golemanma da ganongma 1985 wels aseve Seadares miTebi ganmeorebiTi qorwinebis

Sesaxeb

ganmeorebiT qorwineba

1. mjera yvelaferi kargad iqneba, radgan Cven yvelafers sworad gavakeTebT;

2. yovelTvis ifiqre jer sxvebze;
3. xazi gausvi dadebiT mxareebs da yuradRebas nu miaqcev uaryofiTs;
4. Tu rame ise ar gamodis, dafiqrdi ra ar gamovida wina qorwinebaSi da
Seecade rom es ar gameordes;
5. adamianis pirovnebidan gamomdinare is SeiZleba moiqces an qorwinebaze miTis
mixedviT da ganixilos sakuTari Tavi rogorc wyvilis wevrma, an
ganqorwinebis miTis mixedviT da ganixilos sakuTari Tavi rogorc individma;
6. Cemi _ Cemia da Seni _ Senia;
7. ganqorwineba xdis adamians mniSvnelovnad ufro bedniers, vidre iyo
qorwinebamde;
8. is, rac kargia CvenTvis, mavnea bavSvebisaTvis.

marTalia miTebi qorwinebis Sesaxeb cota iumoriTaa ganxiluli, es miTebi

sakmaod popularulia da maT ganmtkicebas aqtiurad uwyobs xels gabatonebuli
sazogadoebrivi azric. Amas ganamtkiceben eklesia, iuristebi, masmedia,
naTesavebi da megobrebi.

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 ganqorwinebis SedegebTan gamklaveba. ganqorwinebis Semdeg adamians uxdeba
yvelafris Tavidan dawyeba. ojaxma, rogorc sistemam unda Secvalos _
praqtikuli cxovrebis stili, finansebis ganawileba, aseve mSoblebis rolebi,
urTierTobis modelebi da socialuri kontaqtebi.

hateringtoni da misi kolegebi 2 wlis ganmavlobaSi Seiswavliden 96

ganqorwinebul wyvils SvilebiT. maT aRmoaCines, rom bevri qali da mamakaci
ganqorwinebul wyvilebSi Seejaxa problemebs, romelic adre, qorwinebis dros
ar hqoniaT. ganqorwinebuli mamakacebidan bevrs hqonda saxlSi sameurneo da
saorganizacio saqmeebis problemebi, radgan miCveuli iyvnen, rom am sakiTxebs
meuRle agvarebda. zogma aRmoaCina, rom finansebi gayofis Semdeg imdenad
Semcirda, rom Tavis gatana gauWirdaT. bevrma damatebiT samsaxuri daiwyo, rom
meti saxsari eSovna. diasaxlisi qalebi, Cveulebriv, ganicdiden finansur
siZneleebs, gansakuTrebiT Tu yofili qmrebi droulad ar ixdiden aliments.
amis gamo qalebs uxdebodaT samuSaos an damatebiTi samuSaos dawyeba. Sedegad
sul ufro cota dros atarebden bavSvebTan da TiTqmis saerTod ar rCebodaT
dro sakuTari TavisTvis.

saSualo asakis adamianebs, romlebic ukve SeeCvien Tavisi cxovrebis

stils, gansakuTrebiT uWirT ganqorwinebis Sedegebis gadatana. gansakuTrebiT
maSin, Tu uwevT xelaxla dawyeba swavlis, samuSaos moZebna, axali
urTierTobebis awyoba. Cndeba danakargis gancda, sasurveli an arasasurveli
damoukidebloba da avtonomia, zogjer sruli simartove.

umravlesoba ganqorwinebas ganixilavs rogorc marcxs. arcTu iSviaTad

Cndeba damcirebis da ususurobis gancda. ganqorwineba, orivesTvis, yovelTvis
aris dartyma, stresi. SesaZlebelia ganqorwinebis iniciatoric ganicdides
sevdas, danaSaulis grZnobas an brazs, magram mainc is ufro akontrolebs
situacias, ufro mzad aris am viTarebisTvis. TiTqos man ukve gaiara yovelive
repeticiaze.

axali cxovrebis awyoba. ganqorwinebis Semdeg qalebs ufro miaCniaT, rom

miiRes “kidev erTi Sansi”. Tumca realurad maT SeiZleba ufro meti problemebi
gauCndeT, vidre mamakacebs. SedarebiT mcirea ricxvi im adamianebis, romlebic
ganqorwinebas Znelad eguebian da stress 10 welic ki ganicdian. aseT
viTarebaSi ganqorwinebul adamianebSi matulobs alkoholizmi, fizikuri
avadmyofoba da depresia. Tumca ganqorwinebul wyvilTa umravlesoba axerxebs
2-3 weliwadSi gaumklavdes sirTuleebs da maT isev uCndebaT keTildReobis
gancda. isini ki, vinc ukeT aawyobs saqmes, isev qorwindebian 3-4 wlis Semdeg.

xelmeored qorwineba ganqorwinebul mamakacebSi 3-jer ufro xSiria,

vidre qalebSi. saSualo asakis mamakacebidan bevri irTavs ufro axalgazrda
cols da aCens Svilebs. zogadad, ganqorwinebas emociurad da fsiqologiurad
ukeT egueba is, visac aqvs sakmarisi finansebi, socialuri statusi da aqtiurad
aris CarTuli sociumSi, aqvs socialuri kontaqtebi.
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Как пережить развод?

Пережить развод: тот, кто хочет сохранить семью, должен бороться до конца
– Статистика разводов в настоящее время выглядит просто пугающе.
– Цифры на самом деле серьезные – в крупных городах расторгается до 80% браков. И
большинство из тех, которые сохраняются, зачастую трудно назвать гармоничными.
Многим видится, что вот встретились двое, полюбили друг друга и решили пожениться, и этого
вполне достаточно для создания семьи. На самом деле, семьи создаются не ОТ любви, а ДЛЯ
любви. Любовь созидается в семейной жизни, и так должно быть…
– Каковы основные причины такого пугающего роста числа разводов в последнее время?
– На мой взгляд, три основные причины разводов такие: это синдром эмоционального выгорания,
клановые конфликты и неготовность к семейной жизни.
К сожалению, очень часто брак заключается тогда, когда люди прошли уже через какие-то тяжелые
сердечные переживания с другими людьми, иногда через «пробные браки». И хотя кажется, что это
проходит бесследно, однако все психотравмирующие ситуации подобного рода оставляют шрамы
в душе человека. Иногда человек сам чувствует в своей душе выгоревшую «пустыню». Встретился,
наконец, «твой» человек, но душа молчит, ей уже нечем любить – нет душевных сил. Поэтому и
надо хранить душевную и телесную чистоту до брака.
«Клановые конфликты» подразумевают нелегкие отношения с тещами, свекровями, и
прочими родственниками. Не секрет, что на этой почве часто ведется скрытая борьба,
противостояние. Если это происходит, нужно становиться более гибкими, уметь подстраиваться, а
не конфликтовать, ведь вся эта «подковерная борьба» может очень серьезно повлиять на брак в
целом.
Не секрет, что в каждой семье свой уклад, свои нормы отношений, свои привычки и традиции.
Структура личности к моменту брака уже сформирована, и двум людям из абсолютно несхожих по
этим параметрам семей будет очень трудно ужиться вместе. Начиная жить вместе, молодые люди
уверены, что смогут «перевоспитать» другого (но не себя!), «если любит – станет таким, как я
хочу!».
Сословное строение общества – это реальность, с которой боролись сто лет, но которое
объективно имеет место в любой стране и в любое время. Для нашего вопроса важно понять, что
когда при разводе называется основной причиной «несходство характеров» – за этим часто стоят,
прежде всего, различные ценностные ориентации супругов, воспитанных в семьях из разных слоев
общества (теперь так говорят). Но на бытовом уровне это проявляется через несостыковки вроде
бы в мелочах, но мелочей этих столько, что за ними уже и главное не просматривается.
И если какое-то время можно прожить вместе на ярких чувствах и положительных эмоциях, то рано
или поздно проблемы несоответствия двух семейных моделей выплывут наружу. Выбор супруга –
это ответственный шаг, и к этому надо относиться внимательно, в том числе стоит прислушиваться
к советам старших – ведь в понятие родительского благословения также вкладывается очень
много. Исходя из жизненного опыта, они часто способны прочертить жизненную перспективу, и
лучше понять, тот ли это человек для дочери или сына.
Третий важный момент – это готовность к семейной жизни. Это должно воспитываться с детства, в
собственной семье. Реальность такова, что неправильное отношение к институту семьи возникает
из-за того, что дети, которые в основном растут в яслях, детском саду, школе – семьи, в полном
смысле этого слова, не видят. Потому что бывают в ней всего несколько часов в день, с

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родителями общаются катастрофически мало и практически не участвуют в семейных делах. И
родители часто живут по разным семьям. То есть человеку, выросшему в такой ситуации просто
неоткуда взять правильную модель построения семейных отношений.
Когда мы отдаем ребенка в школу, там обязательно его проверяют на готовность к школе: смотрят,
может ли он писать, читать, готов ли слушать и воспринимать информацию, может ли спокойно
сидеть длительное время, насколько правильно понимает слова учителя. В зависимости от
степени готовности, ребенка берут в класс определенного уровня.
К любым важным делам, а семейная жизнь – важнейшая составляющая нашей жизни, необходимо
готовиться. Причем, готовы должны быть и мужчины и женщины. Я думаю, что в большей степени
это касается женщин, потому что мужчина органически более нацелен на внешний мир, на
социальную реализацию, на достижение «внешних целей». Задача женщины – выстроить семью,
создать атмосферу, внутренний климат.
– В чем основные составляющие готовности женщины к семейной жизни?
– Это чувство ответственности за другого человека, умение любить, прощать, что-то потерпеть.
Со стороны женщины, как это ни банально может прозвучать, – это, прежде всего, умение
выполнять повседневные задачи, которые – основа жизни, стабильности, причем выполнять
быстро и хорошо. Сегодня приходится заново открывать смысл тех постулатов, которые оказались
отброшены и забыты в современном обществе. Прежде всего, элементарные домашние дела
молодая женщина должна выполнять с радостью, не задумываясь, не требуя за это особой
благодарности, и не ставя себе в заслугу. Потому что это одна из ее основных функций в семье,
потому что если она не создаст эту почву семейной жизни – быт, то никто это не сделает за нее.
Конечно, обеспечить нормальное течение своих семейных дел часто не легче, чем управлять
каким-нибудь предприятием, но это необходимо. Семейная жизнь подразумевает много простой,
мелкой, кропотливой работы, и к этому необходимо готовиться. Вспомним, что раньше, при выборе
спутницы жизни, обязательно обращали внимание на то, умеет ли девушка готовить, убирать,
шить, вязать.
У современных девушек совершенно иные представления о семье – заручившись сомнительными
лозунгами, типа «я не прачка, а женщина», «я создана для любви, а не для работы», и т.п.,
женщины шагают в семью, ожидая комплиментов, цветов, постоянного внимания, праздника, и не
желая отдавать частичку себя ежедневно. Жизнь в гармоничной семье – это действительно
праздник, но совершенно не такой, какого ожидают, насмотревшись сериалов.
Умение вести хозяйство – часть жизни женщины, ее предназначения. К тому моменту, когда
девочка вырастет, и соберется замуж – эти навыки должны быть сформированы до уровня
автоматизма. Современных девочек развивают в основном в другом направлении – английская
школа, танцы, вокал, теннис, коньки, драматическая студия. Все это прекрасно и важно для
развития личности, для того, чтобы быть интересным человеком, и это обязательно пригодится в
жизни. Вопрос в правильной расстановке акцентов – главное вырасти хорошей хозяюшкой, а все
остальное пригодится при воспитании детей, для помощи мужу.
Кроме того, хочется отметить, что женщина передает свое эмоциональное состояние мужчине.
Нужно это понимать, и уметь сдерживать неоправданные всплески эмоций, ведь они неизбежно
влияют на всю семью. Часто говорят, что в доме должно пахнуть пирогами, но дело даже не в
самих пирогах, а в том эмоциональном состоянии, которое передается через процесс
приготовления, через улыбку, через мир в доме.
Приходилось слышать, как современные мужчины называют жену «моя судорога» – это оттого, что
они никогда не знают когда она их «сведет». Нервозность может проявиться в неожиданный
момент и по неожиданному поводу, и вылиться в истерику. Нужно учиться сдерживать негативные
проявления. Домашний очаг должен быть не местопребыванием, а действительно теплым и
родным домом.
– А в чем должна заключаться готовность мужчины?
– Вспомним, что мужчина настроен на действие и реализацию. Состоятельность мужчины как мужа

59
должна быть, прежде всего, в готовности взять на себя ответственность за близких, за решение
более глобальных вопросов, связанных с жизнью семьи. Мужчина встраивает себя и свою семью в
эту жизнь. Надо понимать, что от мужчины зависит не только материальный, но и социальный
статус семьи. Он «представляет» семью во внешнем мире. Конечно, он также должен быть
достаточно трудолюбив, чтобы выполнять тяжелую домашнюю работу, которая женщине не под
силу. И конечно для мужчины очень важно научиться мягко и с юмором относиться к женской
сущности, ведь у женщины бывают и перепады настроения, и недомогания, и неожиданные
эмоции, которые зачастую связаны не только с психологией, но и с физиологическими циклами
(беременность, кормление и др.). Мужчине не обязательно включаться в эти женские проблемы,
надо их просто понимать, и уметь правильно, с любовью и мягкостью к ним относиться.
Современным мужчинам навязывается определенный стереотип поведения, с экранов, со страниц
журналов, в актуальной литературе – что ты за мужчина, если бежишь домой, и больше у тебя
ничего нет, сплошная скука и рутина, нужно, мол, иметь еще что-то, «настоящие мужские
интересы». И многие на этот крючок попадаются, а дальше начинаются необратимые процессы. А
отсюда возникают такие разрушительные вещи как пьянство, измены, игромания, и т.д. –
соблазнов во внешнем мире много.
В этом плане мужчине надо уметь отстраиваться от внешней системы давления, учиться
принимать решения самостоятельно, ответственно, понимать, что от его решений будет зависеть и
судьба семьи.
– Мы так часто думаем, что не понимаем друг друга, а на самом деле, возможно, не понимаем роли
полов, и их предназначения, поэтому многие и многие пары «наступают на одни и те же грабли». В
целом, миры мужчины и женщины немного разные?
– Миры мужчины и женщины – не совсем одно и то же, есть различия, это надо понимать и
принимать. Удел женщины – внутренний мир семьи, очаг, а мужчина – воин. Представьте, что муж
каждый день возвращается из боя, в котором защищает семью и ее интересы, а жена каждый день
поддерживает огонь в очаге – тогда будет легче понять потребности другого, и свои собственные
функции.
В этом муж и жена должны дополнять друг друга, четко представлять и понимать роли полов в
семье.
И мне хотелось бы предостеречь молодые пары от желания чрезмерного самообнажения друг
перед другом, к этому надо деликатно, осторожно относиться и с женской, и с мужской стороны.
Всегда должно оставаться что-то недосказанное, какая-то тайна, кусочек собственной душевной
территории – тайна мужского и женского сердца. Ведь есть вещи, которые нужно понимать, но не
обязательно обсуждать. И в то же время важно учиться говорить на языках друг друга, понимать
особенности друг друга, в том числе психологические – в этом залог более теплых отношений. Это
тоже труд, и может быть самый важный в жизни.
– «Все несчастливые семьи – несчастны по-своему». Но в чем могут состоять общие причины того,
что семья не складывается?
– Из-за неправильного взгляда на семью до брака, разочарования неизбежны. Даже если двое не
имеют ни малейшего представления о том, что такое подлинная семейная жизнь, и семейные
дела, сама эта жизнь неизбежно покажет все как есть, приведет к соответствующим выводам,
продемонстрирует бреши. Корни разочарований – в ложных ожиданиях. Женщина представляла
себе вечный праздник и восхищение, признание своих талантов, а получила будни, полные забот, и
не заметила подлинных семейных побед и радостей, которые сторицей окупают все наши труды.
Мужчина хотел спокойствия, стабильности и уюта в месте, которое считает своей «берлогой», и
куда возвращается после «охоты», а получил истерики и «вечную яичницу» с бутербродами.
Значит, в чем-то были неправы оба.
К тому же семья – это долготерпение. А многие сейчас просто не приучены терпеть, сдерживаться,
прислушиваться. В жизни случаются самые разные ситуации, бывает, что сами отношения
«заболевают», и нужно иметь много терпения, чтобы понять, изменить, исправить, пережить. Этого

60
терпения зачастую не хватает. Здесь не сложилось – значит не мое, пойду дальше. На самом деле
это путь от себя к себе.
– А бывают ли связаны разводы с неправильно поставленными целями?
– Это происходит в том случае, когда люди рассматривают семью не как мирное существование со
своей второй половиной, а решают свои социально-психологические проблемы. Например, была
несчастная любовь – нужно срочно выйти замуж, чтобы что-то кому-то доказать, или просто «пора
жениться», или одолел страх одиночества. Все это не та основа, на которой должна строиться
настоящая семья. Такое «объединение» людей нестабильно.
– Есть два сценария, типичные для разводов, которые вызывают много вопросов. В первом случае
женщины недоумевают, как может мужчина, глава семьи, за нее ответственный, вдруг взять и
бросить эту семью на произвол судьбы. Во втором – неясно, почему мужчины часто уходят именно
от успешных в плане карьеры женщин.
– По поводу первого сценария могу сказать, что, это может быть связано с теми самыми разными
установками, вынесенными из собственной семьи. Возможно, у такого человека ответственность
просто не воспитывалась, и ответственность за семью он на самом деле не брал никогда.
Кстати, это часто бывает в случае, когда мальчика воспитывает одна женщина. Она неосознанно
делает его «удобным для себя» – человеком, который должен понимать только ее, и отвечать на
ее нереализованные жизненные запросы. Такой мужчина совершенно не умеет встраиваться в
другие модели, и в силу женоподобной фактуры не способен брать ответственность за другую
женщину. Он обычно строит отношения в модели подчинения, или ломается. Когда мужчины
растят сыновей, в них больше проявляется ответственность, чувство плеча сильнее развито.
Что касается второй модели – то это тоже довольно типично. На самом деле, женщины делают
карьеру на том огромном запасе жизненной энергии, который изначально дан им, чтобы родить и
вырастить нескольких детей. Эту энергию они бросают во внешний мир. А это мир мужчин.
Соответственно женщина начинает вести себя как мужчина, вступая в конкурентные отношения на
мужском поле. А муж начинает ощущать нехватку чего-то женственного, нежного, заботливого. Как
это ни банально звучит, но это истина, проверенная временем. Когда женщина начинает проявлять
жесткость, демонстрировать интеллект, доминировать по деловым качествам, ее компетентность в
делах начинает превосходить мужскую, мужчина начинает чувствовать себя неуютно.
Нужно иметь мудрость, чтобы сдерживаться. Ведь карьера приходится на период расцвета
личности – 30-40 лет. Но расцвет не вечен, все проходит. И когда женщина начинает подводить
итоги, получается, что ее подлинная карьера и счастливый финал жизни – это семья, дети. И это
именно то, куда стоило вкладывать свои недюжинные силы и способности. Что такое карьера по
сравнению с тем, что можно недодать своим детям, с тем, что могут стать несчастными близкие
люди или рухнет семья?!
– Ситуация, когда одна из сторон объявляет о желании развода, – это шок, потеря будущего,
боль…
– Ситуацию развода можно назвать неадекватной, ненормальной для общего течения жизни. И,
конечно, оба участника этих драматических событий пребывают в сложном эмоциональном
состоянии. Вроде, жизнь выстраивается по определенному (тягостному) руслу: знакомые,
обстоятельства – все подталкивает к принятию этого решения. Фактически оба становятся
заложниками уже сложившихся обстоятельств.
Тому, кто уходит, тоже нелегко. Прежде чем принять решение о разводе, человек долго
переживает, ведь оно повлечет за собой глобальные перемены в жизни, а это очень непросто.
Бывает иллюзия, что уходя, человек идет от плохого к хорошему, более яркому, светлому. На
самом деле ему предстоит пройти через боль, и совсем не обязательно, что он придет в более
радостное место. Эта боль просто так не исчезает. Уходя, человек сам проходит через страдания и
всех вокруг проводит через это. Тяжелые рубцы остаются на всю жизнь, и проблемы иногда
десятилетиями тянутся как шлейф. Часто люди, имевшие несколько браков и осмыслившие свой
опыт, говорят, что могли бы ужиться с любым из партнеров, если бы вели себя правильно, и не

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делали резких шагов. Вообще резкие шаги делать очень опасно. Проблему лучше решать там, где
она возникает, а не создавать новые проблемы, вовлекая в это новых людей.
– В ситуации развода, каким должен быть путь личности?
– Первая реакция того, от кого уходят, – это долгий и мучительный поиск причин в себе: чем я не
хорош, где ошибся, что сделал не так. Просматривается буквально каждый день своей жизни,
каждый час, перебираются все значимые и мелкие события. Пересмотр жизни начинается даже не
с момента знакомства, а с детства, в котором можно найти ответ на вопрос «почему я выбрал этого
человека, а не другого?» Через боль души, через мучительное самопознание надо понять, что это
очень важный момент в жизни. Кризисы способствуют духовному росту. Осознание ошибок ведет к
их исправлению.
Конечно, в этот момент становится жаль себя, и каждый видит много ошибок в другом, но в такой
ситуации сваливать вину на него неконструктивно. Важен собственный опыт, важно суметь самому
измениться. Плохо, когда сюда подключаются близкие, которые желая нам добра, настраивают
определенным образом – виня во всем одного, и защищая другого. Получается некое футбольное
поле, где каждый играет и болеет за свою команду. Но эти люди поиграют и уйдут, но останутся
все равно двое.
В стадии разлада, развода, целесообразно прибегнуть к помощи третьей, незаинтересованной
стороны – это может быть священник, семейный психолог, просто авторитетный, мудрый человек.
Третья сторона видит все, как есть, и может сыграть роль зеркала. Но все же хочу подчеркнуть, что
путь осознания, реформации себя надо пройти самостоятельно, и постараться быть максимально
объективным к ситуации и к себе. Это единственный конструктивный путь.
Не со всеми советуйтесь. Подруги будут говорить «где твоя гордость, он тебя недостоин», друзья
будут говорить «ты мужик, а не тряпка, зачем ты позволяешь с собой так обращаться». И все это
только усугубляет конфликт, не решая ни одной проблемы.
Нам не просто так даются испытания – когда кажется, что мир рушится, от человека требуется
осознать ошибки, «вычистить» душу, раскаяться. Дело в том, что до момента кризиса мы живем
зачастую во власти гордыни, а когда беда приходит, начинаем искренне осознавать свою
неправоту, и искренне каяться. Отчасти, это урок покаяния. Боль души нельзя снять никакими
таблетками – интеллектуальный новокаин еще не придуман. Может наступить краткосрочный
эффект от успокоительных и антидепрессантов, но это скорее, чтобы снять физиологические
симптомы. Боль не утихнет по-настоящему, пока не произойдет работа внутри себя, работа по
вычищению плохого, и исправлению ошибочного.
– Часто бывает так, что когда ты осознаешь свои ошибки, многое уже изменил, и готов меняться к
лучшему дальше – тот, кто ушел, уже не дает тебе шанса. Он принял решение и начал новую
жизнь. Ты и рад бы начать строить отношения по-другому, да поздно.
– Поздно на самом деле никогда не бывает. Есть случаи, когда, даже разведясь и пожив отдельно,
попытавшись построить новые семьи, люди сходятся снова. То есть все не фатально. И пытаться
исправить ошибки можно на любой стадии развода. Думаю, что тот, кто хочет сохранить семью,
должен бороться до конца. Тут надо исходить из принципа – «делай, что можешь, и будь, что
будет».
Сил жалеть не стоит, а вот со средствами надо быть осторожнее. Во-первых, хочется
предостеречь от разнообразных гаданий и приворотов – это опасная и вредная вещь, это насилие
над человеком. По-настоящему достучаться можно только до свободного сознания. Во-вторых, в
случае, когда вернуть жену хочет мужчина, он может выбирать решительные, активные действия, а
женщине в такой ситуации стоит быть крайне осторожной в выборе средств. Тут скорее требуются
деликатность, мягкость, ласка. Когда женщина проявляет излишнюю активность, это раздражает,
срабатывает естественный защитный механизм, ведь мужчина сам, по определению, выполняет в
жизни «активную» роль, и от подобной агрессии со стороны женщины начинает «убегать».
Но бороться нужно, ведь Бог не просто так соединяет двух людей, и отмахиваться, рвать
решительно – это не лучший путь. Что Бог соединил, то человек разъединить не может, любовь,

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придя в сердце единожды, остается в нем навсегда – все это известные истины. Но нам нужны
огромные силы, чтобы суметь правильно пройти через ситуацию развода, сделать правильные
выводы, принять правильные решения. Годы, прожитые вместе, – это не мусор, это часть нашей
души. И часто бывает, что кризисные ситуации приводят к благу – люди очищаются, меняются к
лучшему, проходя через горнило таких испытаний. И иногда соединяются в новом качестве.
Кроме того, на стадии осознания ошибок, на грани разрыва – возникает ощущение, что надо
«почувствовать» жизнь так, как мы чувствуем воду, учась плавать.
А ведь нельзя научиться плавать, только лишь прочитав теоретическую литературу. Нужно
почувствовать воду вашего конфликта и научиться плавать именно в этой воде. Прислушаться к
сердцу, и оно подскажет – да, вот здесь я что-то сделал не так, перебрал, а вот это было
правильно. Важно не врать себе в этот момент, прикрываясь чужим мнением, гордыней, или чем-то
еще. Сказать человеку, который уходит: «Ну и иди, мы и без тебя проживем» – это, кроме
критических случаев, будет неправда. Говорить нужно от сердца, например: «Уходя, ты мне
делаешь очень больно. Но я тебя все равно люблю…».
Необходима искренность. Во-первых, так вы попробуете преодолеть обиду, которая, как известно,
крайне разрушительна, во-вторых, вашей душе будет гораздо спокойнее – высказать хорошее, не
держать в себе, чтобы потом не было больно за то, что мог сказать, но не сказал.
Это из области тайны нашего сердца, а сердце чувствует остроту момента и выбирает нужные
средства. На самом деле семья – это тоже большая тайна, то, что объединяет двоих. И только я
могу сказать именно то, что воспримет его сердце. Даже если человек не вернется, вы не будете
об этом жалеть, потому что ваше сердце его сердцу все сказало. Если его сердце не услышало,
вам уже не будет так больно. Потому что вы не зажали в себе любовь, которая была, и не
обезобразили ситуацию искаженной реакцией (гневом, позой, ответной обидой). Честность и
искренность в данной ситуации – это те составляющие, которые ее оправдывают, и не позволят
потом ни о чем сожалеть.
– Все-таки, если люди расстаются навсегда, когда и как ставится эта внутренняя точка?
– У меня такое ощущение, что настоящей жирной точки не будет никогда. Это будет многоточие,
которое потянется за людьми в перспективу жизни. Супруги и после развода имеют какую-то связь.
Когда один заболевает, другой это может чувствовать на расстоянии. Таков опыт. Все, что мы
пережили, остается с нами на всю жизнь. То есть новые отношения не начнешь с чистого листа, как
это может кому-то представляться. И предыдущие личные проблемы, и годы семейной жизни, и то,
что ты отдал отношениям, – все это останется с тобой навсегда.
Наверное, еще и поэтому нужно пробовать сохранить семью, а не «тиражировать семьи». Конечно,
бывают ситуации, когда всем, включая третью независимую сторону, очевидна невозможность
продолжения отношений, и тогда необходимо принять то, что есть. Важно переработать опыт, а
пока этот процесс продолжается – это сложная и напряженная работа. Если опыт переработан
правильно, то появляются новые силы для продолжения жизни.
– Как пройти кризисный момент развода, справиться с собой, когда в горле ком, и такое чувство,
что тебя накрывают огромные волны страха, боли, обиды – и ты тонешь. Откуда брать силы?
– Действительно, это боль тягучая, гулкая, иногда нестерпимая. И никакие техники, никакое
самоуспокоение не приносят результатов. Это тот случай, когда нужно пережить, перетерпеть – но
не глядя на все пассивно, а работая над собой, переоценивая опыт, переосмысливая жизненные
ценности. Если это будет сделано глубоко и правильно, мы выйдем из испытания разводом
сильными, мудрыми, закаленными, и не обязательно на пепелище, бывает, что и с силами
выстраивать что-то заново.
Часто люди приходят к Богу именно проходя через кризисы, и в этом находят неисчерпаемый
ресурс сил и любви. В сложных ситуациях мы начинаем понимать, что такое ад, начинаем искать
ошибки, огрехи, грехи. И учимся искренне раскаиваться в них.
Важно смотреть в свое сердце и научиться выражать эмоции – когда «больно», значит больно,
если «люблю» – значит люблю. А ведь часто на почве развода начинается некая игра, надевание

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масок, манипуляции, идут в ход нечестные приемы. Это игра на полное разрушение. Когда
ситуация представляется злом – надо подойти к ней с добром, иначе зло умножится.
Добро – это огромный ресурс. Делать добро другим, нуждающимся – это в данной ситуации также
хорошее применение себе. К тому, в чем кажется, нет уже любви, надо подойти с любовью, иначе
нелюбовь умножится. Любовь – также огромный ресурс.
– Пережить разрыв, расставание, развод… Как? С чем?
– С любовью. К себе, к тому, кто тебя оставил, к своим детям. Понять, что все не просто так. С
одной стороны, это плата за ошибки, с другой – хоть в данный момент мы не в состоянии понять
смысл произошедшего, у этого есть определенный смысл.
У старца Паисия есть такой пример – если посмотреть на врача, который своих пациентов
направляет одного на курорт, а другого на операционный стол, можно подумать, что он одного
любит, а второго ненавидит. На самом деле врачу известен прогноз болезни, и в зависимости от
диагноза, он принимает решение о методах. И о том, и о другом он проявляет заботу, только
средства разные. Так же и Бог. К кому-то можно достучаться легко, а кому-то нужны испытания.
Трудные ситуации – это и есть хирургические операции. Их можно и нужно пережить, оправиться.
Когда пройдет время, и мы сможем посмотреть на все с позиции прожитого, более отстраненно, то
сможем ответить на вопрос «зачем?». Все события в жизни взаимосвязаны, и каждая ситуация
содержит некий дар для нас. Но в этой точке мы не видим перспектив, полное осознание придет
потом, надо проявить терпение, и работать над собой.
В самые трудные моменты надо благодарить. Когда душа болит, сердце ноет, слезы льются
градом, а в голове кипяток – надо говорить «Слава Богу за все!» Если есть будущее у
существующих отношений, то это должно быть на основе истинной любви, искренности, прощения,
если суждено отпускать – то с чистым сердцем.
Ермакова Людмила Федоровна
Источник: http://perejit.ru/main/razvod

No one enters into a marriage expecting it to fail. Still, more than 20 percent of first marriages end in divorce within
five years, and 48 percent of marriages dissolve by the 20-year mark, according to 2006-2010 data from the
government’s National Survey of Family Growth.1 Separation and divorce are emotionally difficult events, but it is
possible to have a healthy breakup.

Cooperation, communication and mediation

The end of a marriage typically unleashes a flood of emotions including anger, grief, anxiety and fear. Sometimes
these feelings can rise up when you least expect them, catching you off guard. Such a response is normal, and over
time the intensity of these feelings will subside. In the meantime, be kind to yourself. Researchers have found that
people who are kind and compassionate to themselves have an easier time managing the day-to-day difficulties of
divorce.2

Try not to think of the breakup as a battle. Divorce mediation is often a good alternative to courtroom proceedings.
Trying to work things out yourself can be frustrating and self-defeating as the problems that contributed to your
divorce are likely to re-emerge during divorce negotiations. Research shows that mediation can be beneficial for
emotional satisfaction, spousal relationships and children’s needs. 3

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Sitting down and speaking with your soon-to-be-ex-spouse may be the last thing you want to do, but cooperation and
communication make divorce healthier for everyone involved. Talking things through with a psychologist may help you
reach coordinated decisions with a minimum of conflict.

It can be difficult to remember important details when emotions are running high. Pick a time when you’re feeling calm
to write down all the points you want to discuss. When you do sit down with your soon-to-be-ex-spouse, use the list as
your guide. Having a “script” to work from can take some of the emotion out of face-to-face communication. If in-
person discussions are still too difficult, consider handling some of the details over email.

When kids are involved

Divorce can be a traumatic experience for children, but research suggests that most children adjust well within two
years following the divorce; on the other hand, children often experience more problems when parents remain in high-
conflict marriages instead of splitting up.4 During a divorce, parents can do a lot to ease the child’s transition. Do your
best to keep any conflict away from the kids. Ongoing parental conflict increases kids’ risk of psychological and social
problems.5

It’s often helpful for divorcing parents to come up with a plan and present it to their children together. And, keep the
lines of communication open. Kids benefit from having honest conversations about the changes their family is
experiencing.

In many cases, sudden change can be hard on children. If appropriate, give them a few weeks’ notice before moving
them to a new home, or before one spouse moves out. It can be helpful to minimize changes as much as possible in
the months and years following a divorce.

Kids do better when they maintain close contact with both parents. Research suggests that kids who have a poor
relationship with one or both parents may have a harder time dealing with family upheaval. Parent education
programs that focus on improving the relationship between parents and their kids have been shown to help children
cope better in the months and years following the divorce.6

Taking care of yourself

The changes brought on by separation and divorce can be overwhelming. But now more than ever, it’s important to
take care of yourself. Tap into your support network, turning to family and friends for assistance and comfort. Formal
support groups can also help you cope with the many emotions of a marriage ending.

To stay positive as you start a new chapter, try getting involved in activities you used to love but haven’t done in a
while. Or try new hobbies and activities. Stay physically healthy by eating right and getting exercise.

How psychologists can help

Divorce is a difficult time for the entire family. Divorcing spouses and their children can benefit from speaking to a
psychologist to help them deal with their emotions and adjust to the changes. Psychologists can also help you think

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carefully about what went wrong in your marriage so you can avoid repeating any negative patterns in your next
relationship.

To find a professional psychologist in your area, visit APA’s Psychologist Locator.

Additional Resources

• Making stepfamilies work

• Breaking up is hard to do: Challenges of same-sex divorce
• That’s mine! Property division in divorce

References

1. Key Statistics from the National Survey of Family Growth

2. Sbarra, D. A., Smith, H. L., and Matthias, R. M. (2012). When leaving your ex, love yourself: Observational
ratings of self-compassion predict the course of emotional recovery following marital separation.
Psychological Science, 23(3): 261-269.
3. Shaw, L.A. (2010). Divorce mediation outcome research: A meta-analysis. Conflict Resolution Quarterly,
27(4): 447-467.
4. Kelly, J.B. (2012). Risk and Protective Factors Associated with Child and Adolescent Adjustment Following
Separation and Divorce. In K. Kuehnle and L. Drozd (Eds.), Parenting Plan Evaluations: Applied Research
for the Family Court (49-84). New York, Oxford University Press.
5. Kelly, J. B. (2005). “Developing beneficial parenting models for children following divorce.” Journal of the
American Academy of Matrimonial Lawyers, 19: 237-254.
6. Velez, C.E., Wolchick, S.A., Tein, J.Y., and Sandler, I. (2011). “Protecting children from the consequences of
divorce: A longitudinal study of the effects of parenting on children’s coping processes.” Child Development,
82 (1):244-257.

Thanks to psychologists Lisa Herrick, PhD, Robin S. Haight, PsyD, Ron Palomares, PhD, and Lynn Bufka, PhD, who
assisted with this article.

The full text of articles from APA Help Center may be reproduced and distributed for noncommercial purposes with
credit given to the American Psychological Association. Any electronic reproductions must link to the original article on
the APA Help Center. Any exceptions to this, including excerpting, paraphrasing or reproduction in a commercial
work, must be presented in writing to the APA. Images from the APA Help Center may not be reproduced.

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Home » Division 20 » Publications » Adult Development & Aging News » Examining the importance of Division 20...

Adult Development & Aging News | October 2013

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President’s Message

Examining the importance of Division 20 in the field of psychology of aging.

By Bill Haley

During the past year, while I've been president-elect of the division, I've thought a lot about the challenges that we
face as a division. As someone who has been in the field of aging for 30 years, I see aging research and
psychological practice with older adults as having come a very long way. I teach an undergraduate course in
Psychology of Aging, and it's not at all challenging to find interesting work that's done at the state of the science
across areas as diverse as neuroscience, cognition, personality, social, and clinical psychology. I see an increasing
number of universities turning out strong psychology PhDs who focus on aging, and the caliber of scholars who win
our divisional awards is impressive. At an institutional level, APA has gone from an organization that largely ignored
aging issues to one that is an important voice promoting the value of psychological science and practice in addressing
the needs of an aging society. APA has also made huge strides in recognizing and advancing clinical geropsychology,
with APA endorsing Guidelines for Psychological Practice with Older Adults and with ABPP accreditation in
geropsychology proceeding successfully.

Despite these successes in our field, Division 20 faces a serious challenge in terms of membership. We are having a
difficult time engaging junior colleagues to join APA and the division and in continuing membership. Many of our
members are themselves aging and moving into non-dues-paying status. When I talk to junior colleagues, many don't
see the point of being a part of APA or the division. This has caused me to reflect on what being a part of Division 20
has meant for me and what to tell colleagues about why being a member of APA and Division 20 is valuable.

I didn't study aging in graduate school. In fact, my clinical psychology program didn't offer a class or a lecture on
aging, and I never saw a client over age 50 in our clinic. I happened on aging when I completed my internship at the
University of Washington-Seattle and found myself without a job. I took an NIMH postdoc in geriatric psychology and
made research and practice with older adults a specialty after that very positive experience.

In my early years doing aging research, I didn't know many colleagues with interests in aging. I hadn't been a part of
one of the large training programs of the period, and I didn't have many senior level colleagues to provide me with
mentorship and opportunities. In the early years of my career, I was fortunate to have a number of senior Division 20
colleagues step up and provide me with key support. One early example was Powell Lawton. While Powell was editor
of Psychology and Aging®, I submitted a paper with good ideas, good but limited data and a weak statistical approach.
Instead of rejecting my paper, or sending me a pro forma revise and resubmit letter, Powell wrote a letter detailing just
how I might deal with the statistical issues in my paper, while taking into account the limitations of my sample size. His
guidance helped me publish my first paper in Psychology and Aging in 1987, and the paper ended up being widely
cited and a key to my future success.

Margaret Gatz is another senior Division 20 colleague who stepped up and gave me some major opportunities in my
career. Although I hadn't gone to USC, I began to notice Margy attending my presentations at GSA and APA and
encouraging me and my work. Margy also gave me a major opportunity by supporting my appointment to the editorial

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board of Psychology and Aging in 1993. Around that time, Margy and I were asked to write a book chapter together
reporting on the proceedings of the 1992 National Conference on clinical training in psychology. Margy treated me like
a colleague, and let me be first author on this work. This was a huge boost to me. This kind of generosity seems to be
part of the tradition of Division 20. It's a group that truly cares about this field and in supporting and mentoring the next
generation of scholars and clinicians. I think many of us share a missionary zeal for this field and are invested in the
success of junior colleagues.

When I was first appointed to be associate editor of Psychology and Aging in 2003, I sent out one of my first
manuscripts as action editor to a senior colleague (whom I won't name) I had met through Division 20. She provided a
great review, but also privately chided me for sending this paper out for review at all, instead of triaging it. This was a
great and important lesson for me that really helped me to do a better job in the future. It's great to be a part of a
community of colleagues who call them as they see them and set you straight every once in a while.

I could continue this for a long time … so many Division 20 members have helped me in my career and become good
friends. Besides senior level scholars, Division 20 has helped me develop a peer network for support. It's been great
to see others who completed their PhDs around the same time I did become successful leaders in our field. It's always
a joy to see these colleagues at APA and GSA meetings and talk about the new challenges we face in running
programs, maintaining grant support and mentoring students.

Division 20 has also offered me many opportunities to be a part of APA activities that are very important for advancing
opportunities for psychologists who do aging research and practice, and that contribute to the public good. I've
participated in APA task forces on primary care and end-of-life issues. Being a part of these activities, I was able to
make sure that aging issues were a major component of the discussion. I was a part of the APA Presidential Task
Force a few years ago that developed the APA Caregiver Briefcase, which has brought information about evidence
based assessment and intervention to psychologists who aren't specialists in this area. Through APA's Office on
Aging, I've been able to provide commentary and support for APA's responses to major initiatives that really matter for
psychology and the public, such as the IOM report on the Mental Health Workforce for Geriatric Populations, and the
National Plan to Address Alzheimer's Disease. I haven't been a member yet, but APA's Committee on Aging also has
a major role in advocating for psychological science within APA and agencies like the NIA. APA is a very important
force for good in the field of aging, and being an APA member and Division 20 member allows psychologists to
support and participate in these efforts.

In summary, being a part of APA and Division 20 has been a key part of my professional identity and success over 30
years in the field of psychology of aging. I can't imagine that my career would have been as successful or fulfilling
without the opportunities, connections, and friendships I have gained through Division 20. Throughout my presidential
year, I'm going to ask some colleagues to share their stories about what Division 20 has meant to them in our
newsletter. For everyone reading this, I urge you to share your stories with colleagues, encourage them to join the
division, and do what you can to make Division 20 thrive.

Best wishes to all, and I'll look forward to seeing many of you at GSA.

inShare0

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თემა4.

xandazmuloba

Zvel romSi saSualod cxovrobdnen 22 weli.

1900 wels dabadebulebi cocxlobden 50 wlamde.

1930 wels dabadebulebi _ 60 wels aRwevden.

dRes 65 welze meti asakis ufro metia, vidre ruseTis, iaponiis,

safrangeTis, germaniisa da avstraliis mosaxleoba erTad. xolo 100 wlianTa
raodenoba rekordulia kacobriobis mTel istoriaSi da maTi ricxvi matulobs.
69
 statistikuri monacemebiT yoveli mesame bavSvi, romelic 2013 wels
daibada britaneTSi, icocxlebs aranakleb 100 wlisa.

fizikuri da kognituri ganviTareba

Cvens sazogadoebaSi xandazmulebi xSirad aRiqmebian stereotipulad.

stereotipi SeiZleba iyos dadebiTic (magaliTad: moxucebi mosaxleobis sakmaod
SeZlebuli kategoriaa; moxucebi potencialuri politikuri Zalaa; isini bevrni
arian da politikurad aqtiurebi arian; moxucebi advilad Sedian urTierTobaSi
sxvebTan; keTilebi arian; moxuci adamianebis umravlesoba gamoirCeva simwifiT,
cxovrebiseuli gamocdilebiT da sibrZniT; isini saintereso adamianebi arian da
sxv.) da uaryofiTic (magaliTad: moxucebis umravlesoba Raribia; moxucebi,
rogorc wesi, sustebi da avadmyofebi arian; moxucebis umravlesoba kargad ver
asrulebs samuSaos, Sromisunariani araa; moxuci adamianebi ver iReben
siaxleebs, axalgazrdebTan SedarebiT nakleb SemoqmedebiTi arian; isini nela
azrovneben, mexsiereba ar uvargaT da axal rames cudad swavloben; moxucebis
umravlesoba socialur izolaciaSi cxovrobs da martoobiT itanjeba da sxv).

kvlevebma aCvena, rom damokidebuleba moxuci adamianebisadmi xSirad

ambivalenturia _ isini erTdroulad keTilganwyobilic arian da sul
yvelafriT ukmyofilo wuwuna adamianebic. Tumca zogadi stereotipi
uaryofiTia, gansakuTrebiT fizikuri mimzidvelobisa da gonebrivi
SesaZleblobebis daqveiTebis mimarT.

kvlevebma aCvena, rom SemoqmedebasTan da inovaciebTan dakavSirebiT,

mowifuli tvini axalgazrdaze ukeT muSaobs. virjiniis universitetis
kognituri daberebis laboratoriis direqtoris, fsiqologiis
profesoris timoTi soltxausis azriT, miTi asakTan erTad kognituri
unarebis dakargvis Sesaxeb emyareba ara sistematur kvlevebs, aramed
crurwmenebs. iTvleba, rom wlebTan erTad adamianis tvini kargavs
Semoqmedebis, adaptaciis, gadawyvetilebis miRebis unars. Tumca
mecnierebi gviCveneben, rom sinamdvileSi xdeba piriqiT.
upirveles yovlisa, asakTan erTad Zlierdeba empaTiis unari:
adamians uadvildeba sxvisi gageba. xandazmuli adamianebi ukeT axerxeben
sxva adamianebis saWiroebebisa da sakuTari mignebebis dakavSirebas.
garda amisa, xandazmuli adamianebis didi gamocdilebis safuZvelze
metia albaToba, rom gadawyvetilebis miRebisas xanSiSesuli adamiani
axalgazrdebze ukeT gaiTvaliswinebs momavlis perspeqtivas. Tumca erTi
pirobiT. SemoqmedebiTi rCebian is adamianebi, romlebic asakTan erTad
ganagrZoben rTuli SemoqmedebiTi amocanebis gadawyvetas, ismenen
gansxvavebul mosazrebebs, wyveten arastandartul da rTul sakiTxebs,
70
swavloben enebs, mogzauroben, dros uTmoben sports. es aris kognituri
energiisa da efeqtiani SemoqmedebiTi saqmianobis SenarCunebis saidumlo.
“miuxedavad imisa, rom 100 weli misruldeba, vazrovneb axla _
gamocdilebis daxmarebiT _ bevrad ukeTesad, vidre maSin roca oci wlis
viyavi”, _ Tqva rita levi-montalCinim, neirobiologma, nobelis premiis
laureatma (romelic 1986 wels miiRo fiziologiasa da medicinaSi, roca
77 wlis iyo) Tavisi asi wlis iubilis ceremoniaze. igi aqtiurad
monawileobda politikur cxovrebaSi rogorc italiis republikis
senatori. gardaicvala 2012 wels 103 wlis asakSi.
hedda bolgari _ cnobili fsiqoanalitikosi, marto cxovrobda
Tavis saxlSi los-anjelesSi, muSaobda pacientebTan 20 sT kviraSi.
kiTxulobda leqciebs, dadioda konferenciebze. is iyo Wkviani,
warmatebuli qali, romelic cxovrobda aqtiuri da damoukidebeli
cxovrebiT. da iyo 103 wlis. gardaicvala 2013 wlis agvistoSi.
hedda bolgarma diplomi aiRo 1936 wels. misi maswavleblebi iyvnen
froidis uaxloesi mimdevrebi. muSaobis staJi _ 75 weli. mas bevri
pacienti hyavda. zogierTi xandazmuli iyo. “me myavs pacienti qali,
romelic 91 wlisaa. Zalian uxaria, rom SeuZlia urTierToba
TerapevtTan, romelic masze ufrosia. is fiqrobs, rom axalgazrdebs ar
SeuZliaT gaigon misi problemebi. vfiqrob, is bevr rameSi sworia” _
ambobda h.bolgari. yvelas aocebda misi Sromismoyvareoba da naTeli
goneba. “iciT, bolo 80 weli sportiT didad ar viyavi dakavebuli” _
seriozulad ambobda is. Tumca, rodesac 101 wlis iyo, gaitaca iogam da
masTan saxlSi modioda iogas maswavlebeli. misi azriT, didxans da
bednierad rom icxovro, sworad unda ikvebo (TviTon bolo 14 weli iyo
vegetarianeli), kargad unda gamoiZino. rac mTavaria, miiRo is rac xdeba
Sens garSemo da Zalian ar unda inerviulo siZneleebis gamo.
gansakuTrebiT imaze, rac jer ar momxdara. “unda datkbe cxovrebiT da
ar ifiqro cudze”. hedda ambobda, rom mowiful asakSi sulieri
janmrTelobisaTvis unda gesmodes, rom wlebs moaqvT aramarto
danakargi, aramed upiratesobebic. “adamianebi bevrs laparkoben imaze, ras
vkargavT asakTan erTad, da aviwydebaT is, rasac viZenT. es usamarTlobaa.
wlebTan erTad Cven viRebT damoukideblobas, vswavlobT sakuTari Tavis
gagebas, nakleb SfoTviani vxdebiT. asaki gvaZlevs saukeTeso saSualebas
davfiqrdeT sakuTar cxovrebaze, aRar gavbrazdeT sakuTar Tavze
araswori gadawyvetilebebis gamo da moviSoroT danaSaulis grZnoba”.
es magaliTebi naTlad gviCvenebs, rom xandazmulobaSic SeiZleba
adamianma SeinarCunos Zalebi da sicocxlis xalisi. Tumca xSirad
sazogadoebaSi arsebuli stereotipebi da cxovrebis stili ar uwyobs
xels xandazmulebs arsebuli potencialis gamoyenebaSi.

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 2009 wels Catarda 2,969 xandazmulis gamokiTxva (Pew Research Center
Social & Demographic Trends survey on aging). maT garda gamokiTxes xandazmuli
adamianebis ojaxis wevrebic da axloblebic (800 respodenti). erT-erTi
kiTxva iyo: “rodis iwyeba xandazmuloba?” gamokiTxulTa azriT,
saSualod 68 wlidan. Tumca 30 wlamde adamianebi fiqroben, rom adamiani
xandazmuli xdeba sanam 60 wlis gaxdeba. am mosazrebas eTanxmeba 65 da
meti asakis adamianebis mxolod 6%. asakis garda, genderic axdens
gavlenas pasuxebze. qalebi, saSualod, amboben, rom adamiani moxuci
xdeba 70 wlis asakSi. kacebi ki Tvlian, rom 66 wlis asakSi. kiTxvaze:
“Tqven moxuci xarT?” gamokiTxulTa didma nawilma upasuxa: “ra Tqma
unda ara!” 65-74 wlis respodentebis mxolod 21% Tqva, rom Tavs grZnoben
moxucad. maT Sorisac ki, vinc iyo 75 da meti wlis, mxolod 35% Tqva,
rom Tavs moxucad grZnobs. xolo kiTxvaze: “ra asakamde gindaT rom
icxovroT?” saSualo pasuxi iyo 89 weli. Tumca 8% surs as wels
gadascdes. 2002 wlis analogiuri gamokvlevis Tanaxmad ki saSualod
sasurveli asaki iyo 92 weli.

Tu gaviTvaliswinebT, rom sicocxlis xangrZlivoba saSualod 80-85

welia, gamodis, rom adamiani 60 wlis Semdeg kidev did xans cocxlobs.
es periodi pirobiTad SeiZleba daiyos 4 aTwleulad.

xandazmulobis adreuli periodi (60-dan 69 wlamde) moxucebuli,

65 wlis Semdeg adamians arcTu ise saxarbielo momavali elis:

problemebi janmrTelobasTan, arasakmarisi saarsebo saSualebebi, martooba.
aseTi mosazreba gamoTqva 1975 da 1981 wlebSi aSS-Si Catarebuli kvlevis
monawileTa umravlesobam. Tumca 65 wlis respodentebis umravlesobam
ganacxada, rom TviTon jerjerobiT am problemebs ar Sejaxebian.

60 wlamde adamianebi ufro gadaafaseben xolme asakTan dakavSirebul

negatiur faqtorebs. aseT daskvnamde mividen Pew kvleviTi centris mecnierebi.
sxvadasxva asakis amerikelebis gamokiTxvis monacemebiT, axalgazrdebisTvis
xandazmuli asaki asocirebulia avadmyofobasTan, seqsualuri aqtivobis
daqveiTebasTan, damoukideblad manqanis tarebis uunarobasTan da sxva
kliSeebTan.

ramdenad gansazRvravs genetika Cvens janmrTelobas

xandazmulobaSi? memkvidreobaze metad mniSvnelovania cxovrebis stili.
1998 wels Svedma mecnierebma gadawyvites SeeswavlaT adamianebi,
romlebsac hqondaT saerTo genebi, magram gansxvavebuli cxovrebis
stili. am mizniT ikvlies tyupebi, romlebic daaSores bavSvobaSi da
isini sxvadasxva pirobebSi izrdeboden. Tu yvelaferi damokidebulia
mxolod memkvidreobaze, tyupebi daaxloebiT erTnair formaSi unda

72
iyvnen, aRzrdisa da socialuri mdgomareobis gansxvavebis miuxedavad.
aRmoCnda, rom maTi janmrTelobis mdgomareoba mniSvnelovnad
gansxvavdeboda. mecnierebma daaskvnes, rom Cveni fizikuri mdgomareobis
mxolod 20-30% ganisazRvreba genebiT, danarCeni ki cxovrebis im stilzea
damokidebuli, romelsac Cven virCevT. tyupebis sxva kvlevaSi, romelic
londonis samefo kolejSi Catarda, aTi wlis Semdeg, erTmaneTs
adarebdnen fizikuri varjiSis moyvarul da-Zmebs da im da-Zmebs,
romlebic fizikur datvirTvebs erideboden. aRmoCnda, rom pirvelebi
berdebodnen ufro nela, vidre meoreni. calkeul SemTxvevebSi isini cxra
wliT “axalgazrdebic” ki iyvnen.
aRmoCnda, rom rac ufro asakovania adamiani, miT ufro bednieria.
aseT daskvnamde mivida fsiqologiis profesori laura karsensteni,
romelmac kolegebTan erTad stenfordis universitetidan 2009 wels
Caatara kvleva, romlis drosac erTi kviris manZilze adevnebden Tvals
18-dan 94 wlamde asakis 200 moxalisis emociur mdgomareobas. aRmoCnda,
rom yvela grZnobda daaxlovebiT erTnairi raodenobiT dadebiT
emociebs, magram dadebiTi gancdebis xangrZlivoba SesamCnevad meti iyo 60
wels gadacilebulebs Soris. axalgazrdebTan SedarebiT, es adamianebi
ufro mdgradebi aRmoCnden negatiuri movlenebisadmi: uaryofiTi
emociebis raodenoba mniSvnelovnad naklebi qondaT, xangrZlivoba ki
mokle.

2010 wels telefoniT gamokiTxvisas (gamokiTxes 840 aTasi amerikeli),

aZlevden SekiTxvebs maT emociur mdgomareobaze. analizma aCvena, rom stresis
da SfoTvis done radikalurad qveiTdeba 50 wlis asakis Semdeg, xolo 55
wlidan iwyeba bednierebis donis zrda. es erTnairadaa mamakacebSic da
qalebSic.

amerikis ganaTlebis departamentma gamoaqveyna angariSi, romelSic

dadasturebulia, rom xandazmuli adamianebi aranakleb, xSirad ki ufro
metadac warmatebuli arian ucxo enebis SeswavlaSi, vidre bavSvebi.
asakTan erTad tvini ukeT aRiqvams gramatikul kavSirebs da
sityvaTwarmoebis Taviseburebebs, xolo cxovrebiseuli gamocdileba da
motivacia exmareba progresis ufro Cqara miRwevaSi. mecnierebis mier
Catarebulma kvlevam aCvena, rom is, rasac miiCnevden adre xanSiSesuli
adamianebis uunarobad, sinamdvileSi aris araSesatyvisi saswavlo
masalebi: saWiroa am masalebis Sesabamisoba mxedvelobisa da smenis
asakobriv TaviseburebebTan.

es umniSvnelovanesi, gardatexis periodia. adamianebis umravlesobas

am zRvaris gadabijebis Semdeg uwevs Segueba axal rolTan, isini unda

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Seecadon gaumklavden aramarto samsaxuris, aramed TanamSromlebis,
megobrebis dakargvas da gamoiyenon am aTwleulis xelsayreli mxareebic.
am asakSi xSirad mcirdeba Semosavlebi (pensiaze gasvlis an arasruli
samuSao dRis reJimze gadasvlis gamo), megobrebisa da kolegebis ricxvic
TandaTan mcirdeba. icvleba sazogadoebis molodinebi xanSiSesulebis
mimarT, radgan sazogadoeba Tvlis, rom am asakis adamianebi aRar arian
uwindeburad energiulebi, damoukideblebi da SemoqmedebiTad aqtiurebi.
aseTma damokidebulebam SeiZleba gamoiwvios xanSiSesuli adamianebis
demoralizeba, gansakuTrebiT imaTi, vinc jer kidev Zveleburad
janmrTelia da ZalebiT savse. bevri aseT damokidebulebaze marTlac
reagirebs cxovrebis tempis daqveiTebiT.
fizikuri Zala am periodSi marTlac ramdenadme sustdeba, da es
SeiZleba problema gaxdes maTTvis, vinc warmoebaSi aris dasaqmebuli
fizikuri SromiT. magram bevrs am periodSi SeuZlia iamayos
energiulobiT _ isini gamudmebiT eZeben axali tipis saqmes. bevri
pensiaze gasuli adamiani janmrTelia, ZalebiT savse da sakmaod
ganaTlebuli. isini Tavisufal dros (romelic axla gacilebiT meti
aqvT) iyeneben TviTrealizaciis, sazogadoebrivi Tu politikuri
saqmianobisaTvis. zogierTi regularulad aris dakavebuli sportiT da
seqsualurad aqtiuria. bevr pensioners surs Zveleburad gamocdileba da
codna gadasces sxva adamianebs (axalgazrda kolegebs, mozardebs) _ rame
akeTos da vinmes aswavlos.
es asakobrivi jgufi Zalian gansxvavdeba pensiaze gasvlis asakis
mixedviT. umravlesoba pensiaze gadis 65 wlis, zogi ki ukve 55 wlis
asakSi, zogic 75 wlamde muSaobs. pensiaze gasvlis gadawyvetileba
nebismier asakSi damokidebulia individis janmrTelobis mdgomareobaze,
samuSaos tipze. aseTi gadawyvetilebis miRebaze SeiZleba gavlena
moaxdinos problemebma interpersonalur urTierTobebSi (meuRlis
avadmyofobam an iman, rom megobrebis umravlesoba ukve pensiazea) da
garemos faqtorebma (ojaxis materialuri mdgomareoba Tu kargia,
SeuZlia adre gavides pensiaze da Tu cudi _ didxans cdilobs muSaobiT
daexmaros ojaxs).

xandazmulobis Sua periodi (70-dan 79 wlamde) beri,

am periodSi ufro meti cvlilebebi xdeba, vidre manamde mTeli ori
aTwleulis manZilze. 70 wlis Semdeg bevri kargavs sul ufro met
axloblebs, megobrebs da xSiria avadmyofoba. interpersonaluri
urTierTobis wris daviwrovebis garda, am asakis adamianebi imasac
eguebian, rom naklebad monawileoben formalur organizaciebSi. 70
wlianebi arian mouTmeneli da gaRizianebadi. sul ufro meti problemebi
Cndeba janmrTelobis mxriv. qalebSic da mamakacebSic qveiTdeba

74
seqsualuri aqtivoba, bevr SemTxvevaSi meuRlis an seqsualuri
partnioris dakargvis gamo. mTavari amocana am asakSi aris wina
aTwleulSi mopovebuli pirovnuli reintegraciis SenarCuneba. miuxedavad
amisa, yvela ar xdeba ususuri invalidi. xSirad adamianebi, romlebmac
gadaitanes infarqti, insulti an onkologiuri daavadeba cocxloben
medicinis miRwevebisa da cxovrebis jansaRi wesis daxmarebiT. Tumca
unda aRiniSnos, rom cxovrebis bolo aTwleulebSi qalebis xvedriTi
wili populaciaSi mniSvnelovnad metia mamakacebis xvedriT wilze.

gviani xandazmulobis periodi (80-dan 89 wlamde) mxcovani

80 wlianTa umravlesobas, adrindelTan SedarebiT, ufro uZneldeba
garemosTan Segueba da urTierTqmedeba. bevr maTgans Wirdeba ufro
ubralo/martivi cxovrebis pirobebi, minimaluri raodenobis
sayofacxovrebo problemebiT, rac maT ganmartoebis saSualebas aZlevs.
Tumca gare stimulebic saWiroa, radgan am asakSi adamianebis
umravlesobas ar aqvs unari sxvisi daxmarebis gareSe SeinarCunos
socialuri da kulturuli kontaqtebi.
bevri, magram ara yvela, 85 wlis adamiani gamoirCeva susti
janmrTelobiT. susti janmrTelobis mqone moxuc adamianebze zrunvis
mniSvnelobas yvela qveyanaSi acnobiereben. magram susti janmrTeloba
aucileblad ar gulisxmobs invalidobas an sxvaze srul
damokidebulebas. longinos gamokvlevis Tanaxmad, am asakis
respodentebSi invalidobis mZime SemTxvevebi mxolod 10% hqonda, Tumca
25% saavadmyofoSi weliwadSi erTxel mainc xvdeboda. aSS-Si 85 wels
gadacilebulTa umravlesoba cxovrobs saxlSi (maTgan 30% marto) da
mxolod 25% moxucTa saxlebSi an sxva dawesebulebebSi.

Rrma sibere (90-dan 99 wlamde)

90 wlis adamianebis Sesaxeb mecnierebas naklebi monacemebi aqvs
wina asakebTan SedarebiT, radgan Znelia informaciis sistematurad
miReba maTi janmrTelobis da socialuri pirobebis Sesaxeb. miuxedavad
imisa, rom janmrTelobis problemebi sul ufro Rrmavdeba, am asakis
adamianebi pouloben saqmianobis iseT formebs, romelic saSualebas
aZlevs Tavisi SesaZleblobebi ukeT gamoiyenon. 90 wlis fsiqiatri
qalbatoni, romelic kidev eweoda praqtikas, xazs usvamda am asakis iseT
upiratesobas, rogoricaa samsaxurTan dakavSirebuli daZabulobisa da
pasuxismgeblobis tvirTis moxsna. Tu wina wlebis problemebi warmatebiT
iyo gadaWrili, cxovrebis mecxre aTeuli SeiZleba iyos savse
sixaruliT, simSvidiT da kmayofilebis grZnobiT.

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daberebis fizikuri aspeqtebi
dabereba aris universaluri da gardauvali procesi. mas
eqvemdebareba sxeulis yvela organo. optimalur pirobebSic ki yvela
organo da sistema erTdroulad da erTnairi siswrafiT ar berdeba.
ramdenadac daberebis procesi TandaTanobiTia da sxeulis sistemebis
umravlesobas ki aqvs mniSvnelovani rezervebi, daberebis bevri efeqti
Tavs ar iCens adreuli da saSualo xandazmulobis periodamde.
janmrTelobasTan da cxovrebis Cveuli riTmis cvlilebasTan
dakavSirebuli SesamCnevi problemebi, romlebic daberebiT aris
ganpirobebuli, Cndeba mas Semdeg rac 70 wels kargad gadaabijebs
adamiani. 1979-1992 wlebis monacemebiT, cxovrebis xangrZlivoba
mamakacebSi naklebia, vidre qalebSi. yvela rasisa da genderul jgufebSi
sicocxlis saSualo xangrZlioba yvelaze maRalia TeTrkanian qalebSi.
organizmis yvela sistemis Sromisunarianobis daqveiTeba da
sensoruli funqciebis Sesusteba, Cveulebriv, Tan sdevs siberes _ magram
yvelasTan ara. moxucebi, romlebmac SeinarCunes fizikuri forma da
aqtiuroba, sxvadasxva testebs ar asruleben susti janmrTelobis mqone
axalgazrdebze naklebad. aseve Znelia imis mtkiceba, rom cvlilebebi am
asakSi mxolod daberebis biologiuri procesis Sedegia. bevr adamians,
romlebmac sibereSi smena dakarges, gadatanili aqvs raime daavadeba, an
ubeduri SemTxveva. magaliTad, didi xnis mwevelebs sibereSi SeiZleba
gauCndeT sunTqvis problemebi; moxuc qals welis tkivilebi roca
awuxebs, SesaZlebelia adre simZimeebis aweva uwevda da sxv. adamianis
cxovrebis wesi, daavadebebi da ubeduri SemTxvevebi _ yvelafers Seaqvs
Tavisi wvlili daberebaSi.
Tumca aris saintereso gamonaklisebic. 2010 wels indoeli glexi
ramjiT raghava 94 wlis iyo, rodesac gauCnda pirveli vaJiSvili da 96
wlis asakSi – meore vaJi. meuRle gaicno 86 wlis asakSi – masze orjer
axalgazrda. ojaxis sarCenad igi dReSi cxra saaTs muSaobs yanaSi.
janmrTelobisa da energiis SesanarCuneblad yoveldRe iRebs or litr
rZes, bevr bostneuls da nuSs. xorcs saerTod ar Wams.

morfo-funqcionaluri cvlilebebi sibereSi

am asakSi cvlilebebi exeba garegnobas, grZnobis organoebs,
kunTebs, Zvlebs da moZraobas, aseve Sinagan organoebs.
garegnoba. Cndeba WaRara, damWknari kani, naoWebi Rrmavdeba, icvleba
siarulisa da dgomis manera. kani xdeba nakleb elastiuri, mSrali da
Txeli. sibereSi naoWebs aCens kanqveSa cximovani qsovilebis ganleva. kani
gamoiyureba rogorc pergamentis qaRaldi an daWmuWnuli qaRaldi.
matulobs meWeWebi sxeulze, saxeze, Tavis kanze. wvrili sisxlZarRvebi

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xSirad skdeba da kanze Cndeba sisxlCaqcevebi, SeiZleba gaCndes
pigmenturi laqebi. kanis cvlilebebi SeiZleba rig SemTxvevebSi
gamowveuli iyos mzis sxivebis, qaris an meqanikuri dazianebebis
zemoqmedebiT. mze arRvevs kanis ganaxlebis unars, radgan ultraiisferi
sxivebi gansakuTrebiT Zlierad moqmedebs kanis daberebaze. Tumca
ramdenadme kompensacia SesaZlebelia kargi kvebiT, janmrTelobaze
zrunviT da mzisgan Tavis dacviT.
81 wlis asakSi karmen del orefaisma furori moaxdina niu iorkis
modis kvireulze. 2012 wlis 11 seqtembers igi orjer gamovida podiumze.
karmeni 15 wlidan muSaobs modelad. man TiTqmis 10 wliT datova podiumi
roca 40 wlis xdeboda. magram dabrunda 50 wlis asakSi. am droisTvis
gaWaRaraveba daiwyo da Tmebis SeRebvis magivrad yvelas daumtkica, rom
silamaze yvela asakSia SesaZlebeli. mas Semdeg muSaobs wamyvan
dizainerebTan da fotografebTan. darwmunebulia, rom silamazis
saidumlo yoveldRiur varjiSsa da sakuTari sxeulis SegrZnebis
unarSia.

grZnobis organoebi. adamianis SegrZnebebi (smena, mxedveloba, gemo

da ynosva) daberebasTan erTad sustdeba. adamians axla meti dro
sWirdeba ama Tu im sensoruli sistemidan informaciis misaRebad.
sensoruli funqciebis dasustebis xasiaTi da xarisxi individebSi Zalian
gansxvavebulia.
smena. friad gavrcelebulia smenis gauareseba, gansakuTrebiT
mamakacebSi. smenis daqveiTeba praqtikulad cxovrebas urTulebs
xandazmuli adamianebis TiTqmis mesameds. Cveulebriv, es aris smenis
msubuqi dakargva, rac imaSi gamoixateba, rom Wirs xmauris fonze xmebisa
da bgerebis garCeva. garda amisa, asakTan erTad uaresdeba smeniTi
mgrZnobeloba maRali tonebis mimarT, romelic metyvelebaSi gvxvdeba
(magaliTad, “s”, “S”, “C” da “f” bgerebis mimarT). amis gamo zogierTi
moxucebuli SeiZleba mogveCvenos rogorc uyuradRebo da Znelad
moazrovne adamiani, Tumca sinamdvileSi maT ubralod ar esmiT ras
eubnebian. sxvebi ki imis gamo rom ar esmiT, SeiZleba gaxden Caketili da
eWviani.
mxedveloba. moxucebs uWirT obieqtze mzeris fokusireba. amis gamo
xandazmul adamianebs xSirad ar siamovnebT mkveTri ganaTeba.
axalgazrdebisagan gansxvavebiT, maT uWirT kontrastebis aRqma da
wvrili detalebis garCeva. asakovani adamianebi kargaven mxedvelobis
simaxviles _ uWirT wvrili detalebis garCeva (safosto yuTze gvaris
garCeva, kibis safexurebisa da xaliCis ornamentis garCeva, gazeTebis
kiTxva). asakTan erTad sul ufro Zneldeba konkretuli sagzao niSnis

77
garCeva sxva niSnebs Soris. amitom niSnebis ganTavseba ganmeorebiT da
standartul adgilas, exmareba xandazmulebs maT aRqmaSi.
gemo da ynosva. gemos SegrZnebebi sibereSi TiTqmis ar icvleba.
gansakuTrebiT kargad aris SenarCunebuli sitkbos SegrZnebis unari.
simwaris SegrZeba ki umniSvnelod qveiTdeba. hipertonikebi sxva
xandazmul adamianebze metad gamoarCeven marilis gemos.
gemosTan SedarebiT SesamCnevad uaresdeba ynosva. SesaZloa amis
gamo xandazmulebs uWirT kerZSi calkeuli komponentis gemos gamorCeva.
ase Tu ise, sensoruli funqciebis cvlilebebma SesaZloa xeli Seuwyos
saWmlis momnelebeli sistemis problemebis ganviTarebas, rac xSiria
xandazmulebSi.
kunTebi, Zvlebi da moZraoba. daberebis procesSi mcirdeba kunTuri
masa. Sedegad mcirdeba gamZleoba da Zala. kunTuri qsovilis Semcirebis
gamo SesaZlebelia wonis Semcireba adreuli an saSualo mowifulobis
xanis wonasTan SedarebiT.
sibereSi adamianebis simaRle, Cveulebriv, 3-5 sm-iT naklebia
axalgazrdobasTan SedarebiT. es xdeba xerxemalSi diskebis SekumSvis,
ZvlebSi kalciumis Semcirebis gamo. Zvlebi xdeba myife, xSirad tydeba da
cudad xorcdeba. amas osteoporozs uwodeben. osteoporozi
gansakuTrebiT xSiria qalebSi, radgan menopauzis Semdgom periodSi
sisxlSi mcirdeba estrogenebis raodenoba. dacema da motexiloba
SeiZleba gamoiwvios vestibularuli aparatis cvlilebebmac. zogadad
kunTebis muSaoba neldeba, wvrili motorikis koordinacia uaresdeba,
xolo reaqciis dro izrdeba.
kvlevebma aCvena, rom regularuli fizikuri varjiSebi amcirebs
kunTebis dasustebis process. 87 wlis asakis 37 mamakacis gamokvlevam
aCvena, rom maT, vinc regularulad asrulebda varjiSebs, kunTuri Zala
moemata 113%-ze metad da SeZles bevri moqmedebis Sesruleba sxvebis
daxmarebis gareSe.
fauji singxma sirbili daiwyo rodesac 80-ze metis wlis iyo.
manamde cota xniT adre daqvrivda da indoeTidan sacxovreblad gadavida
SvilTan londonSi. mTeli dRe saxlSi jdoma fermeris
janmrTelobisTvis usargeblod miiCnia, Tanac depresiuliao saxlSi
jdoma _ gavida quCaSi da daiwyo sirbili. rva wlis varjiSis Semdeg _
89 wlis asakSi _ man monawileoba miiRo londonis maraTonSi da eqvs
saaTze nakleb droSi dafara manZili. kidev sami wlis Semdeg, 95 wlisam,
maraToni gairbina ukve 5 saaTsa da 40 wuTSi da msoflio rekordi
daamyara 90 welze meti asakis monawileTa kategoriaSi. bolo 12 welSi
sul rva maraToni irbina da miRebuli Tanxebi gadaricxa saqvelmoqmedo
organizaciebSi. forma rom SeenarCunebina, yoveldRe 15 kilometrs
faravda siaruliT da sirbiliT. amasTan, ar eweva, ar Wams Semwvars,

78
vegetarianelebis dietas icavs, ar svams da SeZlebisdagvarad erideba
cud adamianebs. da bevrs iRimeba. swored Rimili, ambobs fauji singxi,
exmareba formis SenarCunebaSi.
Sinagani organoebi. daberebis procesSi aseve mcirdeba gulis,
filtvebisa da sxva Sinagani organoebis sarezervo SesaZleblobebi.
adreuli mowifulobis xanaSi am organoebs SeuZliaT normaze 4-10-jer
ufro intensiurad muSaoba. saSualo asakSi da Semdgom organizmis es
rezervebi nela, magram ganuxrelad mcirdeba. yoveldRiur cxovrebaSi
xanSiSesuli adamiani SesaZloa verc ki amCnevdes Tavisi organizmis
rezervebis Semcirebas da didi xnis Semdeg raime samuSaos Sesrulebisas
igrZnos es (magaliTad, ezos gawmenda Tovlisgan).
rezervebis daqveiTeba gansakuTrebiT Zlierad vlindeba sicxeSi da
siciveSi. bevri xandazmuli adamiani nela axdens adaptirebas sicivesTan
da ufro swrafad iyineba, vidre axalgazrdobaSi, rac saSiSia
janmrTelobisTvis. analogiuri problemebi uCndebaT moxucebs sicxeSic,
gansakuTrebiT fizikuri datvirTvis dros. miuxedavad amisa, Tu
xandazmuli adamianebi moqmedeben nela da iTvaliswineben sicxisa da
sicivis zemoqmedebas, maT SeuZliaT bevri iseTi ramis gakeTeba, rasac
axalgazrdobaSic umklavdeboden.
imunur sistemaSic xdeba cvlilebebi. sibereSi sustdeba imunuri
sistema da adamianebi naklebad arian daculi mikroorganizmebisa da
daavadebebisgan.

janmrTeloba, daavadebebi da kveba.

janmrTelobis cvlileba gvian xandazmulobis xanaSi SeiZleba iyos
qronikuli xasiaTis, an dakavSirebuli kvebiT moTxovnilebebTan, an
daniSnuli wamlebis arasworad miRebiT gamowveuli.
qronikuli daavadebi. bavSvobaSi avadmyofoba xSirad mwvaved
mimdinareobs _ didxans ar grZeldeba da kulminaciis dros aqvs sicxe.
xandazmulebs, piriqiT xSirad awuxebT qronikuli daavadebebi _
romlebic xSirad meordeba an ar rCeba. yvelaze xSiria xandazmulebSi
arTriti, gul-sisxlZarRvTa sistemis daavadebebi, hipertonia, aseve
mxedvelobisa da smenis darRvevebi. moxucebi aseve xSirad ecemian da
iReben travmas. 65 wlis asakis Semdeg adamianebis 85%-s aqvs Tundac erTi
qronikuli daavadeba, 50%-s ki ori an metic.
mcirdeba stresTan gamklavebis unari, xolo stresuli situaciebis
raodenoba SeiZleba gaizardos. stresi SeiZleba gamowveuli iyos
aramarto janmrTelobis problemebiT, aramed pensiaze gasvliT, meuRlis
dakargviT, qronikuli uZilobiT. 65 wlis zeviT sikvdilobis mizezi

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ZiriTadad aris: gul-sisxlZarRvTa sistemis daavadebebi, onkologiuri
daavadebebi da insulti.
kveba. zogjer susti janmrTeloba xandazmulobaSi SeiZleba iyos
cudi an araswori kvebis Sedegi. imis gamo, rom fizikuri aqtivoba
xandazmulobaSi mcirdeba, xolo nivTierebaTa cvla neldeba, moxucebs
sakvebi WirdebaT naklebad, vidre axalgazrdebs. magram ZiriTadi kvebiTi
nivTierebebi maT imdenive WirdebaT, rac axalgazrdebs. amitom bevr xand
azmuls aqvs an Warbi an arasakmarisi wona. zogierTi aris gamxdari da
anemiuri, radgan siRaribe, gaunaTlebloba an daTrgunuli mdgomareoba
xels uSlis rom SeiZinos kvebiTi nivTierebebiT mdidari sakvebi. ufro
xSirad gvxvdeba rkinis, kalciumisa da A da C vitaminebis nakleboba.
gacilebiT ufro rTulia araswori kvebis Sedegad Warbi cximebis
miReba. asakTan erTad organizmi kargavs sxvadasxva saxis cximebis
gadamuSavebis unars. gamouyenebeli cximi grovdeba organizmSi, maT
Soris arteriebis SigniTa kedlebzec. SeiZleba gaCndes folaqebi da
daaviwrovos arteria, rac auaresebs gulisa da sxva organoebis sisxliT
momaragebas. am daavadebas ewodeba aTerosklerozi an arteriebis
gamagreba. es xdeba mizezi bevri gul-sisxlZarRvTa sistemis daavadebis.,
romelic xandazmul asakSi gvxvdeba.
Zvlebsa da kunTebSi mimdinare cvlilebebi iTxoven kvebiTi reJimis
Secvlas. Zvlebi rom ar gaxdes myife, xanSiSesulma adamianebma unda
miiRon preparati kalciumi. ramdenadac mcirdeba saWmlis momnelebeli
sistemis tonusi da xSiria kuWis Sekruloba, sakvebs unda daematos
ujredisi da unda moixmaron meti raodenobiT wyali.
mravali adamiani siberesac da mis moaxloebasac ki tragediad
aRiqvams. magaliTad, Tmis cvenisa Tu gaWaRaravebis gamo xSirad mZime
Soks ganicdis. kosmetikuri saSualebebi am kriziss verafers Svelis.
krizisi, upirveles yovlisa, imas niSnavs, rom uwindeli cxovrebiseuli
normebi Tu Sexedulebebi aRar funqcionirebs. amitomac kriziss mudam
ormagi aspeqti aqvs: is ganaxlebis Sanssac Seicavs da Cveul yofaze
avadmyofuri mijaWvulobis safrTxesac. ganaxlebas Sinagani fericvaleba
mohyveba, xolo Zvelze CabRauWebam SeiZleba panika gamoiwvios.
magram siberis niSnebs SeuZlia sxva mizeziTac migviyvanos
krizisamde. am dros xSirad gveCveneba, TiTqos Cvens cxovrebaSi raRac
arasworadaa, mcdari mimarTeba gvqonda sakuTari Tavisa Tu
cxovrebisadmi, raRac mTavari da arsebiTi gamogvrCa. uecrad viazrebT
drois ulmobel dinebas da gvipyrobs SiSi, romlis gadmocemac ase
SeiZleba: marTlac unda momxdariyo is, rac moxda? nuTu is, rogorc
aqamde vicxovre, Cemi cxovrebis WeSmariti sazrisia? amgvar cxovrebiseul
daskvnas SeuZlia gons mogviyvanos da zogjer gadamwyveti cvlilebebic
SegvaZlebinos. magram zogjer isec xdeba, rom mzardi SiSis dasaTrgunad
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adamiani ama Tu im mavne Cvevas emorCileba, uviTardeba mania an panikaSi
vardeba. amgvar krizisul periodebSi TviTmkvlelobac mosalodnelia,
rac ukiduresi sasowarkveTilebis Sedegia.
am TvalsazrisiT udides safrTxeSi eqcevian is adamianebi, vinc
adreve did simaRleebs miaRwia, vinc cxovrebam gaanebivra da amitom ama
Tu im sikeTis dakargvas Tu masze uarisTqmas Znelad egueba. aseve mosdiT
im adamianebs, romlebic sakuTar warmatebas axalgazrdobas, silamazesa
da pirovnul xibls umadlian. am faseulobaTa dakargvam SeiZleba
imedgacrueba, depresia, melanqolia gamoiwvios da xSirad adamiani
cdilobs, am mdgomareobas alkoholiT Tu sxva msgavsi saSualebiT
gaumklavdes. am kategoriis adamianebi klinikebisa da sanatoriumebis
potenciur da xangrZliv pacientebad iTvlebian.
zemoTqmulis mizezi aucileblad warumatebloba rodia: zogjer es
cxovrebisadmi damokidebulebis iZulebiTi Secvlaa, rasac
pretenziuloba unda vuwodoT. Tuki winaT adamiani iseT garemosa da
warmatebebs iyo SeCveuli, romlebic, SesaZloa, didi Zalisxmevis gareSe
ergo, maSin mas cxovrebisadmi sruliad garkveuli pretenziebi
uviTardeba, xolo rodesac am moTxovnebs ver akmayofilebs,
gawbilebulia. cxovrebisadmi wayenebuli moTxovnebi, miTumetes rodesac
isini adamianis Zalisxmevas aRemateba, Sua asakSi da mis Semdgom, didi
albaTobiT iwvevs kriziss. amgvari moTxovnebi siberisadmi
moumzadeblobaze metyvelebs. SesaZloa aseT adamianebs gavugoT kidec,
rodesac cxovrebis gagrZelebaze uars amboben. cxovrebis piki maT ukan
moitoves da, raki mxolod da mxolod molodiniTa da imedebiT
suldgmuloben, gamodis, rom cxovreba maT ukve veRarafers SesTavazebs,
namdvili fericvaleba aseT SemTxvevaSi SeuZlebelia, radgan is windawin
mzadebas moiTxovs, saamisod ki cxovrebis wina etapebze araferi
gakeTebula.
krizisis sxva mizezad SeiZleba mogvevlinos mouwyobeli cxovreba:
ganuxorcielebeli urTierTobebi, profesia, romelic ar gviyvars, da
romelSic TviTrealizeba ver movaxdineT, uRimRamo, erTferovani da
umizno arseboba. bevri adamiani, Tundac amaSi sakuTar Tavs ar
utydebodes, Tavisi ki ara, sxvisi cxovrebiT cxovrobs imis gamo, rom
risime Sesacvlelad gambedaoba aklia, pasiuria, xelCaqneulia, angariSs
uwevs tradiciebsa da sazogadoebriv azrs, anda TvalTmaqcobs.
cxovrebis ekvatoris Semdeg aseTi yofa xSirad SeuZlebeli xdeba. Tvali
unda gavusworoT samwuxaro sinamdviles; Cveni civilizacia adamianTa
umravlesobisagan iseT saqmianobas moiTxovs, riTac isini mxolod lukma-
purs Souloben. mas ki sayvarel da saintereso saqmed ver aqcev. swored
esaa gansxvaveba profesiasa da dasaqmebas Soris. zogierT adamians
swored Sua asakSi uWirs amasTan Segueba. maTi saqmianoba damRleli da

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mosawyenia, is winsvlisa da ganviTarebis saSualebas ar iZleva da
pirovneba SeZrwunebiT acnobierebs, rom veRarasodes verafers Secvlis.
Tuki adamiani Sinaganad jerac cocxlia da moqmedia, aseT dros
SesaZlebeli xdeba iseTi Zvrebi da cvlilebebi, romlebic mas frTebs
asxams da abednierebs. sxva SemTxvevaSi arsebobs gawbilebisa da
sasowarkveTilebis safrTxe. namdvil xsnad SeiZleba mogvevlinos axali
damamSvidebeli, SemoqmedebiTi Tu sazogadoebrivi saqmianoba, raime
gataceba an hobi, Tundac raRacis an viRacis siyvaruli, ramac SeiZleba
pesimizmisa da gawbilebisagan gvixsnas.
Sua asakSi partniorul urTierTobaTa krizisic Zalze xSiria.
Tuki panikasTan ara gvaqvs saqme, rodesac adamians eCveneba, rom
yovelgvari Sansi xelidan ecleba, gamalebiT cdilobs cxovrebiseuli
SesaZleblobebis dauflebas da imis gancdas, rac jerac ar ganucdia, -
aseT SemTxvevaSi aRmoCndeba xolme, rom didi xnis partniorulma
urTierTobam ar gaamarTla da mxolod tradiciis Tu pragmatuli
interesebis gamo iqna SenarCunebuli. urTierToba aRar viTardeba, an
SesaZloa, es mxolod gveCvenebodes; partniorebs erTmaneTisaTvis
aRaraferi darCaT saTqmeli, sakuTari cxovrebiT cxovroben da imaze
fiqri, rom bolomde ase unda gagrZeldes, Zalze TrgunavT. amgvar
qorwinebebs xSirad Svilebis gulisaTvis mainc inarCuneben; Tu es
Semakavebeli faqtoric ar arsebobs, maSin partnioruli urTierToba
saerTod kargavs azrs da manamde miCqmaluli daukmayofilebloba aSkara
krizisSi gadaizrdeba. zogierTi mainc axerxebs urTierTobis mogvarebas,
raSic ojaxis megobris an fsiqoTerapevtis rCeva-darigeba exmareba. sxva
partniors icvlis, magram ise aRmoCndeba, rom problema maT qorwinebaSi
ki ara, TviT maTSia. es SeiZleba iyos siyvarulis nakleboba, iluziebi
sakuTar TavTan, potenciur partniorTan Tu zogadad cxovrebasTan
dakavSirebiT. Tumca zogierTs mainc umarTlebs da siberis zRurblze
marTlac iwyeben axal cxovrebas.

cvlilebebi kognitur procesebSi xandazmulobaSi

arsebobs azrTa sxvadasxvaoba imis Taobaze Tu ra xarisxiT xdeba
inteleqtualuri unarebis daqveiTeba normaluri daberebis procesSi.
aRmoCnda, rom gonebrivi unar-Cvevebis umravlesoba SenarCundeba.
mexsierebis farTomasStabianma kvlevebma aCvena, rom daberebasTan
dakavSirebuli mexsierebis problemebi ar warmoadgens imdenad
gavrcelebul da seriozul movlenas, rogorc adre egonaT. mexsierebis
bevri problemis provocirebas axdens ara dabereba, aramed sxva
faqtorebi, rogoricaa depresia, aqtiuri saqmianobis Sewyveta an wamlebis
gverdiTi moqmedeba. magram roca kognituri daqveiTeba marTlac xdeba,
magaliTad, informaciis gadamuSavebis siswrafis daqveiTeba, adgili aqvs

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Sesabamis kompensaciasac da yoveldRiur cxovrebaSi xarvezi arc ise
SesamCnevia.
operaciebis Sesrulebis siCqare. xandazmul adamianebTan izrdeba
reaqciis dro, Senelebulia perceptuli informaciis gadamuSaveba da
qveiTdeba kognituri procesebis siswrafe. es nawilobriv SeiZleba
aixsnas imiT, rom xanSiSesulebi axalgazrdebze metad afaseben sizustes.
xandazmulebi testirebisas cdiloben sworad upasuxon yvela kiTxvas da
ufro iSviaTad cdiloben swori pasuxis gamocnobas. testirebis analizma
aCvena, rom 30- da 70-wlianebi standartizebul davalebebs asruleben
gansxvavebuli siswrafiT. SedarebiT martivi kognituri davalebebis
SemTxvevaSi, rogoricaa mexsierebiT Sedareba sxvadasxva sagnebis,
xandazmulebs sWirdebaT 50%-iT meti dro, vidre axalgazrdebs. roca
davalebebi rTuldeba, xandazmulebs orjer da metad ufro didi dro
sWirdebaT warmatebiT pasuxisTvis.
Tumca xanSiSesul adamianebs aqvT kompensaciis SesaZleblobebic.
erT eqsperimentSi xanSiSesuli memanqane qalebi iseve warmatebiT
arTmevden Tavs davalebas, rogorc axalgazrdebi. ram gamoiwvia es?
rodesac eqsperimentatorma SezRuda winaswar wakiTxuli sityvebis
raodenoba, xanSiSesuli memanqane qalebis maCveneblebi daqveiTda,
axalgazrdebisa ki ara. rogorc Cans, swrafad beWdvisTvis isini
cdilobden teqstis ufro didi monakveTebis daxsomebas. es gamocdilebis
Sedegia.
mexsiereba. daxsomebisas informacia jer mcire droiT xvdeba
sensorul mexsierebaSi (sadac inaxeba vizualuri da akustikuri
Tvisebebi), Semdeg gadadis xanmokle anu pirvelad mexsierebaSi, sadac
xdeba informaciis organizeba da kodireba da bolos, gadadis meorad,
anu xangrZliv mexsierebaSi Sesanaxad. arsebobs mesame rigis mexierebac,
romelSic inaxeba Zalian didi xnis win momxdari movlenebi.
xandazmulebSi mesame rigis mexsiereba TiTqmis srulad aris Senaxuli.
isini ukeT ixseneben istoriul movlenebs, vidre axalgazrda adamianebi.
gansakuTrebiT maSin Tu am movlenebis momswre TviTon arian. yvelaze
metad asakobrivi cvlilebebi, gauaresebis saxiT, SeimCneva meore rigis,
anu xangrZliv mexsierebaSi, Tumca arsebobs kompensaciis saSualebac _
xandazmulebs SeuZliaT daiswavlon informaciis axleburad
organizaciis xerxebi. garda amisa, xandazmulTa mexsiereba SerCeviTia:
isini ufro advilad ixsomeben maTTvis ufro saintereso da mniSvnelovan
masalas.

eqsperimentebma aCvena, rom xandazmulebTan daxsomebis efeqturoba

gadasawyveti davalebis xasiaTzea damokidebuli. roca saWiroa masalis
cnoba, maSin daxsomeba mniSvnelovnad ar uaresdeba. mdidari

83
cxovrebiseuli gamocdileba exmareba xanSiSesul adamianebs azriani
masalis ukeT daxsomebaSi, gansakuTrebiT Tu dasaxsomebeli masala
maTTvis nacnob sferos miekuTvneba _ buRalteri ukeT ixsomebs cifrebs
da ricxvebs, xolo filosofosi abstraqtul debulebebs.

moZraoba aumjobesebs mexsierebas. zomieri fizikuri varjiSic ki

aumjobesebs mexsierebas da amcirebs alcheimeris daavadebis risks
pitsburgis universitetis profesoris kirk eriksonis kvlevis Tanaxmad.
man ikvlia 60-80 wlis 120 cdispiri, romlebsac ar hqondaT alcheimeris
daavadeba da nakleb aqtiuri cxovrebis stiliT cxovrobdnen. maT
SesTavazes seirnoba 30-45 wT kviraSi samjer mTeli wlis ganmavlobaSi.
Semdeg gazomes hipokampis moculoba (es aris are tvinSi, romelic
ganagebs mexsierebas). aRmoCnda, rom is gaizarda saSualod 2%-iT.
gaizarda Sublis wilis moculobac, romelic aseve mniSvnelovania
mexsierebisa da gulsisxlZarRvTa sistemisaTvis. amis paralelurad,
profesori lui-ambrozi britaniis kolumbiis universitetidan ikvlevda
70-80 wlis 86 qals, romlebsac hqondaT mexsierebis problemebi. es
cdispirebi dayves sam jgufad: erTSi Zalismier varjiSebs asrulebden,
meoreSi – aerobikas, mesameSi – (romelic sakontrolo jgufi iyo),
martivi fizikuri varjiSebiT iyvnen dakavebulebi. samive jgufSi
datvirTva TandaTan izrdeboda. naxevari wlis varjiSis Semdeg,
“Zalismier” movarjiSeebis 17% ufro efeqturad marTavda moZraobebs,
gaizarda maTi asociaciuri mexsiereba, gaumjobesda sisxliT momarageba
tvinis im nawilebis, romlebic uzrunvelyofen araverbaluri
informaciis amokiTxvas da daxsomebas. aerobikis jgufidan qalebi ukeT
moZraobden da wonasworobasac ukeT icavden, magram kognitur planSi
zrda iyo ufro neli. sakontrolo jgufSi mexsierebis gaumjobeseba ar
SeiniSneboda. amrigad, varjiSsa da ubralod siarulsac ki SeuZlia
aramarto Seamciros kognituri darRvevebis aRmocenebis riski da
Seanelos tvinis zogierTi nawilis degradacia, aramed SesaZlebelia mis
aRdgenasac ki Seuwyos xeli.
mexsierebis gavarjiSebis mniSvnelobaze migvaniSnebs aseve elis
herc-zomeris magaliTi. is iyo araCveulebrivi pianisti. 108 wlis asakSi
yoveldRe dilis 10 saaTze ukravda baxis 24 preludias notebis gareSe.
musikas uTmobda aranakleb 3 saaTisa yoveldRiurad. aseTi disciplina,
misi azriT xels uwyobs tvinis gavarjiSebas. is darwmunebuli iyo, rom
bednieri cxovrebis saidumlo aris gqondes unari iyo madlieri
yvelafrisTvis, rac xdeba. maT Soris ubdurebisac da usiamovnebebisac.
is madlierebiT ixsenebda warsuls, germanelebis sakoncentracio banakSi
yofnis wlebsac ki, sadac ori weli gaatara da Zlivs gadarCa. is
madlieri iyo cxovrebis kibos gamoc, romelic daudgines 83 wlis asakSi.

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97 wlamde yoveldRe curavda auzSi. misi azriT, misi tyupiscali da,
romelsac iseTive genebi hqonda, didi xnis win gardaicvala radgan
pesimisturad iyo ganwyobili da yvelaferSi usiamovnebas xedavda. bolo
wlebSi is cxovrobda londonSi, patara binaSi da ar hyavda damxmare.
yoveldRe kiTxulobda wignebs, TviTon amzadebda sadils (ZiriTadad
qaTami, Tevzi da bostneuli), aucileblad seirnobda xangrZlivad, Tumca
tkivilis gamo uWirda. is xSirad imeorebda, rom “cxovrebaSi cudi
rameebic xdeba, magram yuradReba karg rameebs unda miaqcio”.
gardaicvala 2014 wels 110 wlis asakSi.

inteleqti. xdeba Tu ara inteleqtis TandaTan daqveiTeba

xandazmulobaSi? xandazmulebTan informaciis gadamuSavebis neironuli
meqanizmebi SedarebiT nela funqcionirebs, magram es jer kidev ar
niSnavs inteleqtis daqveiTebas. testebs, sadac fasdeba leqsikuri maragi,
codna, informaciis ganzogadebis unari, am asakis adamianebi sakmaod
kargad arTmeven Tavs. rig SemTxvevebSi sxvaoba axalgazrdebsa da
moxucebs Soris ganpirobebulia ara fizikuri da kognituri
cvlilebebiT, aramed ojaxTan da samsaxurTan dakavSirebuli
garemoebebiT.
daberebis procesSi xdeba im neironebis daSla Tavis tvinSi,
romlebic acetilholins gamoimuSaveben. es ki gonebasustobas (demencias)
an alcheimeris daavadebas iwvevs _ ziandeba jer mexsiereba, Semdeg ki
azrovneba da metyveleba. daavadebidan 5 wlis Semdeg adamiani yvela
orientirs kargavs. gonebasustobisTvis damaxasiaTebeli simptomebi
SeiZleba gamoiwvios mikroinsultebma, aseve arasworma kvebam, alkoholis
moxmarebam, zogierTma samkurnalwamlo preparatma da depresiam.
yvelaze mniSvnelovania:
1. fizikuri mdgomareoba gavlenas axdens saazrovno amocanebis amoxsnis
unarzec. SemecnebiTi funqciebis testirebisas amocanebs ukeT
arTmevden Tavs isini, vinc ukeTes fizikur formaSi iyo;
2. arasaTanado kveba, romelic iwvevs anemias, avitaminozs da sxv.,
SeiZleba uaryofiTad aisaxos gonebriv Sromisunarianobaze. olini,
romelsac Seicavs xorci, Tevzi da kvercxis guli, aucilebelia
tvinSi nervuli impulsebis gadacemisaTvis.
3. alkoholis moxmareba didi xnis ganmavlobaSi, Tundac mcire dozebiT,
iwvevs pirveladi da meoradi mexsierebis gauaresebas. xolo didi
raodenobiT alkoholis moxmareba Cveulebriv xels uSlis adamians
aqtiur cxovrebaSi da normalur kvebaSi.
4. samkurnalwamlo saSualebebs, romelsac adamiani iRebs eqimis
daniSnulebiT Tu TviTmkurnalobis dros, aqvT gverdiTi moqmedeba da
aqveiTeben sifxizlis dones da asusteben yuradRebas.

85
5. inteleqtualuri usaqmuroba. didi xniT avadmyofobis, socialuri
izolaciis an depresiis Semdeg zogi adamiani ver ubrundeba
azrovnebis im dones, romelic manamde hqonda.

Tumca arian adamianebi, romlebic xandazmulobaSic mSvenivrad

azrovneben. amis magaliTad SeiZleba vnaxoT vin arian 2012 wels
universitetebis yvelaze xandazmuli kursdamTavrebulebi:
• tvila bostonma miiRo iutas universitetis diplomi roca 98 wlis
iyo da yvelaze xandazmuli bakalavri gaxda universitetis arsebobis
manZilze.
• Carli bolum daamTavra arkanzasis teqnologiuri universiteti 89
wlis asakSi. swavla 70 wliT adre daiwyo, magram swavlis Sewyveta
mouxda, radgan omSi gaiwvies, Semdeg biznesiT iyo dakavebuli.
• roi vandiverma 76 wlis asakSi miiRo bakalavris xarisxi merseris
universitetSi. manamde 31 weli muSaobda qirurgad da 10 weli
sadazRvevo kompaniis generalur direqtorad.
• col-qmari berti (90 wlis) da vendi (79 wlis) gledvinebi. daamTavres
bukingemis universiteti da miiRes diplomi “mecnierebis istoriis”
specialobiT. isini arian inglisis istoriaSi yvelaze xandazmuli
kursdamTavrebulebi. miuxedavad imisa, rom bertim 14 wlis asakSi
miatova skola, Semdeg samjer miiRo umaRlesi ganaTleba.

«Быть старым — такая же прекрасная и необходимая

задача, как быть молодым»
Герман Гессе о старости

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Старость — это ступень нашей жизни, имеющая, как и все
другие ее ступени, свое собственное лицо, собственную
атмосферу и температуру, собственные радости и горести. У
нас, седовласых стариков, есть, как и у всех наших младших
собратьев, своя задача, придающая смысл нашему
существованию, и у смертельно больного, у умирающего, до
которого на его одре вряд ли уже способен дойти голос из
посюстороннего мира, есть тоже своя задача, он тоже должен
исполнить важное и необходимое дело.

Быть старым — такая же прекрасная и необходимая задача, как быть

молодым, учиться умирать и умирать — такая же почтенная функция,
как и любая другая, — при условии, что она выполняется с
благоговением перед смыслом и священностью всяческой жизни.

Старик, которому старость, седины и близость смерти только

ненавистны и страшны, такой же недостойный представитель своей
ступени жизни, как молодой и сильный, который ненавидит свое
занятие и каждодневный труд и старается от них увильнуть.

Короче говоря: чтобы в старости исполнить свое назначение и

справиться со своей задачей, надо быть согласным со старостью и со
всем, что она приносит с собой, надо сказать ей «да». Без этого «да»,
без готовности отдаться тому, чего требует от нас природа, мы теряем

87
— стары мы или молоды — ценность и смысл своих дней и
обманываем жизнь.

Каждый знает, что старческий возраст приносит всякие тяготы и что он

кончается смертью. Год за годом надо приносить жертвы и
отказываться от многого. Надо научиться не доверять своим чувствам
и силам. Путь, который еще недавно был маленькой прогулочкой,
становится длинным и трудным, и в один прекрасный день мы уже не
сможем пройти его. От кушанья, которое мы любили всю жизнь,
приходится отказываться. Физические радости и удовольствия
выпадают все реже, и за них приходится все дороже платить. И потом,
всяческие недуги и болезни, притупление чувств, ослабление органов,
и различные боли, особенно ночами, часто такими длинными и
страшными,- от всего этого никуда не денешься, это горькая
действительность. Но убого и печально было бы отдаваться
единственно этому процессу упадка и не видеть, что и у старости есть
свои хорошие стороны, свои преимущества, свои утешения и радости.
Когда встречаются два старых человека, им следует говорить не
только о проклятой подагре, о негнущихся частях тела и об одышке
при подъеме по лестнице, но и о веселых и отрадных ощущениях и
впечатлениях. А таковых множество.

Когда я напоминаю об этой положительной и прекрасной стороне в

жизни стариков и о том, что нам, седовласым, ведомы и такие
источники силы, терпения, радости, которые в жизни молодых не
играют никакой роли, мне не подобает говорить об утешениях религии
и церкви. Это дело священника. Но кое-какие дары, которые приносит
нам старость, я могу перечислить. Самый дорогой для меня из них —
сокровищница картин, которые носишь в памяти после долгой жизни и
к которым, когда твоя активность идет на убыль, обращаешься с
совершенно другим участием, чем когда-либо прежде. Образы и лица
людей, отсутствующих на земле уже шестьдесят-семьдесят лет,
составляют нам компанию, глядят на нас живыми глазами. Дома,
сады, города, уже исчезнувшие и полностью изменившиеся, мы видим
целыми и невредимыми, как когда-то, и далекие горы, взморья,
которые мы видели в поездках десятки лет назад, мы снова находим
во всей их свежей красочности в этой своей книге с картинками.

Рассматривание, наблюдение, созерцание все больше становится

привычкой и упражнением, и незаметно настроение и позиция
наблюдающего определяют все наше поведение.

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Гонимые желаниями, мечтами, влечениями, страстями, мы, как
большинство людей, мчались через годы и десятилетия нашей жизни,
мчались нетерпеливо, с любопытством и надеждами, бурно переживая
удачи и разочарования, — а сегодня, осторожно листая большую
иллюстрированную книгу нашей собственной жизни, мы удивляемся
тому, как прекрасно и славно уйти от этой гонки и спешки и отдаться
vita contemplativa (созерцательной жизни).

Здесь, в этом саду стариков, цветет множество цветов, об уходе за

которыми мы прежде и думать не думали. Тут цветет цветок терпения,
злак благородный, мы делаемся спокойнее, снисходительнее, и чем
меньше становится наша потребность вмешиваться и действовать,
тем больше становится наша способность присматриваться и
прислушиваться к жизни природы и к жизни наших собратьев,
наблюдая за ее ходом без критики и не переставая удивляться ее
разнообразию, иногда с участием и тихой грустью, иногда со смехом,
светлой радостью, с юмором.

Недавно я стоял у себя в саду у костра, подбрасывая в него листья и

сухие ветки. Мимо колючей изгороди проходила какая-то старая
женщина, лет, наверное, восьмидесяти, она остановилась и стала
наблюдать за мной. Я поздоровался, тогда она засмеялась и сказала:
«Правильно сделали, что развели костер. В нашем возрасте надо
приноравливаться к аду». Так был задан тон разговору, в котором мы
жаловались друг другу на всяческие боли и беды, но каждый раз
шутливо. А в конце беседы мы признались, что при всем при том мы
еще не так уж страшно стары и вряд ли можем считать себя
настоящими стариками, пока в нашей деревне жив еще самый
старший, которому сто лет.

Когда совсем молодые люди с превосходством их силы и наивности,

смеются у нас за спиной, находя смешными нашу тяжелую походку и
наши жилистые шеи, мы вспоминаем, как, обладая такой же силой и
такой же наивностью, смеялись когда-то и мы, и мы вовсе не кажемся
себе побежденными и побитыми, а радуемся тому, что переросли эту
ступень жизни и стали немного умней и терпимей.

«О старости»

Герман Гессе (1877-1962) - немецкий писатель, лауреат Нобелевской

премии.

89
1952

Источник: izbrannoe.com

Posted on November 4th, 2011 by Dr. Elaine Ducharme

90
cxovreba SeiZleba Zalzed usamarTlo iyos. bevri Cvengani daamwuxra
stiv jobsis gardacvalebam

Life can be so unfair. Many of us have been saddened by the premature death of Steve Jobs. The
loss of such a bright, innovative individual who has contributed so much to society can even
make us feel angry. We ask ourselves, “why”. Many who believe in God get angry and wonder
why God takes wonderful people and even young innocent children and lets criminals live. And
then, of course, there is the question about why God lets people who are elderly or very ill
and want to die, just linger.

My mother-in-law is 97 years old. She was born in Italy and moved to the United States when she
was 6. She has always been a homebody. She cooked, cleaned and took care of her family. And
boy did she cook. Pasta was truly home made. Her fresh baked rolls, bracciolini, ravioli, squash
blossoms and risotto were to die for! She rarely sat down. After her husband died, she moved in
with her sister and ultimately became her older sister’s caretaker. This continued until she was in
her late 80’s and her sister was in her early 90’s.

After she, herself, turned 90 she began to need help for herself. She moved away from her home
and friends and moved in with my sister-in-law who lives in another state. This took some
adjustment (for both of them), of course. I think it is always a bit difficult to take two people who
are used to running their homes in a certain way and ask them to change how they do things. I
recall my sister-in-law’s frustration when Mom would become upset she was using paper plates
for a quick lunch. After all, she had lived through the Great Depression…paper plates were a
waste of money.

As my mother-in-law has become more frail, she would tell us she was simply waiting for the
grim reaper to come and take her. She became too tired to even read. Her hearing has failed and
conversation was difficult, especially with multiple people in a room talking. We have talked
about what she wants to happen when she dies. This was really important for all of us. We hoped
that when her time came, she would simply die peacefully at home. But, unfortunately she had a
mild stroke, fell and had to be hospitalized. She developed pneumonia, and although she survived
all of that, she could no longer be cared for at home.

Within a week, she had left her home, spent hours in an emergency room, a few days in a hospital
and then changed rooms three times in the nursing home before she was finally settled. There
were days she didn’t know who we were or where she was.

The other day I brought her chicken soup and matzo balls. (Yes we have that whole
Jewish/Italian thing in our family). When she was awake, her mind was clear. Maybe that is the
hardest part. She knows what is happening. She knows where she is. She really wants to go
home…not just back to my sister-in-law’s, but to her final home. She is more than ready to go.
She doesn’t like being helpless and just waiting for her life to end. I could see the sadness in her
91
eyes. We held hands, watched some football and a cooking show together for a short while and I
promised her jelly donuts the next time I come to see her. She smiled and told me I could go
home as she was ready to go to sleep for the night. I know she wants to sleep forever. As humans,
when we get to this point in life, we have to wait and wait. We don’t make our pets do this. We
help them leave this world peacefully and with dignity.

Death is a hard topic to discuss. There is so much we don’t understand. But talking helps us
prepare. What are your thoughts?

photo by LZ Creations

About: educharme:
I am a licensed psychologist in Connecticut who has worked with children and families for more than 25
years. An adjunct professor at the University of Hartford, I am the author of "Must I Turn the Other
Cheek," a book about the effects of premature forgiveness on recovery from sexual abuse. I also blog
weekly at WRCH, where I am a monthly guest on their morning radio show, talking about a variety of
mental health issues. I am often asked to provide expert testimony to the courts on issues related to
domestic violence, custody issues and trauma. To learn more about my practice visit my website at
www.drelaineducharme.com

Posted on May 26th, 2011 by Dr. James "Chip" Long

Research has shown time and time again that regular

exercise is an important part of maintaining a healthy lifestyle. This message has been picked up
and popularized by almost every media outlet in the world today. You see it on television, hear it
on the radio, and read it in the daily newspaper. What is not as well-known, however, is the fact
that this is just as important to practice at age 65 as it is at age 25.

In an ongoing effort to improve public awareness on this issue, several groups have joined
together to promote National Senior Health and Fitness Day. This event helps keep older adults
healthy and fit by encouraging more active lifestyles. Fitness for older adults does not have to be

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physically demanding or complicated, and the benefits from these types of activities can be far-
reaching.

There are several websites that can help you take the first steps in establishing a healthier
lifestyle. The National Institute on Aging offers information on the psychological and physical
benefits of maintaining a healthy lifestyle, and the Center for Disease Control and Prevention
outlines several ways to incorporate exercise into your daily schedule.

And please remember, any change that promotes a healthier lifestyle is a good one.

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 fsiqosocialuri ganviTareba xandazmulobaSi

statusis Secvla
individis statusis Secvla xdeba mTeli sicocxlix manZilze.
magram gviani xandazmulobis periodSi statusis Secvla mniSvnelovnad
gansxvavdeba. pensioneris an qvrivis cxovrebaze gadasvla, iseve rogorc
Segueba janmrTelobis gauaresebasTan, xSirad xdeba Zalauflebis,
pasuxismgeblobisa da avtonomiis dakargvis signali. xolo im
adamianisTvis, romelsac sZulda Tavisi samuSao didi xnis ganmavlobaSi,
pensiaze gasvla SeiZleba iyos ganTavisufleba mosawyeni da damRleli
rutinuli samuSaosgan. erTma pensionerma SeniSna: “axla me ufro did
xans vatareb saxlSi, vidre manamde, magram me arasdros ar mimiRia aseTi
sixaruli Cemi baRisgan, rogorc bolo ramdenime wlis ganmavlobaSi, Cemi
umcrosi SviliSvili ki _ namdvili saswaulia. TviTonac ar vici ratom
ar vaqcevdi yuradRebas sxva SviliSvilebs, roca isini am asakSi iyvnen”.

pensiaze gasvlasa da axali stilis cxovrebasTan Seguebaze

mravali faqtori axdens gavlenas: fizikuri janmrTeloba, ekonomikuri
mdgomareoba, garSemomyofTa damokidebuleba, samuSaoTi miRebuli
kmayofilebis moTxovnileba. pensiaze gasvlis pirobebi xSirad
gansxvavebulia qalebsa da mamakacebs Soris.
fizikuri janmrTeloba. didi raodenobiT adamianebi, Tavisi
survilis miuxedavad, toveben samsaxurs janmrTelobis gauaresebis gamo.
levim Seiswavla adamianebis didi jgufi, romlebsac male uwevdaT
pensiaze gasvla. yvelaze kargi mdgomareoba hqondaT, rogorc
mosalodneli iyo, janmrTel adamianebs, romelTac surdaT pensiaze
gasvla. yvelaze cud mdgomareobaSi aRmoCnden isini, visac hqonda cudi
janmrTeloba, ganurCevlad imisa surdaT Tu ara pensiaze gasvla. mizezi
SesaZloa imaSi mdgomareobda, rom cudi janmrTelobis mqone adamianebi
xSirad pensiaze gadian moulodnelad da finansuri da fsiqologiuri
TvalsazrisiT ufro cudad arian momzadebuli. levim aRmoaCina, rom
isini, visac ar surda pensiaze gasvla, Zalian male ganicdiden
daukmayofileblobas, iketeboden sakuTar TavSi da grZnobden
gaRizianebas. garkveuli drois Semdeg ki, Cveulebriv, maTi
damokidebuleba Tavisi mdgomareobis mimarT icvleboda da xdeboda
iseTive, rogorc pensiaze nebayoflobiT gasulebs hqondaT. xolo imaTi
damokidebuleba axali stilis cxovrebisadmi, romlebic avad iyvnen
pensiaze gasvlis momentisTvis, mxolod mcirediT umjobesdeboda.
ekonomikuri mdgomareoba. ekonomikuri mdgomareoba aris erT-erTi
mniSvnelovani faqtori imisa, Tu rogor Seegueba adamiani pensiaze
gasvlas _ rac metad aris adamiani uzrunvelyofili, miT ukeT axdens

94
adaptacias axal statusTan. martoxelebi, Cveulebriv cxovroben ufro
siRaribeSi, vidre daqorwinebulebi. qalebi ufro xSirad arian SedarebiT
Raribebi, vidre mamakacebi. garda amisa, xanSiSesulTaTvis ufro rTulia
siRaribes daaRwion Tavi, gansakuTrebiT maTTvis, vinc sam welze metxans
aris aseT duxWir mdgomareobaSi.
garSemomyofTa damokidebuleba. Tu is adamianebi, romelTa azric
mniSvnelovania pensionerisTvis, _ misi megobrebi, nacnobebi _ dadebiTad
uyureben pensiaze gasvlas,Segueba axal mdgomareobasTan gaadvilebulia.
samuSaoTi miRebuli kmayofilebis moTxovnileba. pensiaze gasvla
gansakuTrebiT rTulia maTTvis, vinc samuSaos garda dakmayofilebas
veraferSi poulobda _ naklebad ainteresebda kiTxva, Semdgomi
ganaTleba da ganviTareba, sazogadoebrivi saqmianoba, ar hqonda hobi.
Cveulebriv, nakleb ganaTlebuli, ekonomiurad cudad uzrunvelyofili
da sazogadoebriv-politikuri interesebis ar mqone adamianebi kidev
ufro cud mdgomareobaSi aRmoCndebian xolme. SesaZloa es aiZulebs
bevrs pensiaze gasvlis Semdeg imuSaon Tundac arasruli dRe.
qalebis gasvla pensiaze. imis gamo, rom qalebi nakleb anazRaurebas
iReben, Cveulebriv, pensiaze gasvlisas isini nakleb arian
uzrunvelyofili mamakaci pensionerebTan SedarebiT. gansakuTrebiT
martoxela an ganqorwinebuli da daqvrivebuli qalebi. pensiaze gasvlas
ufro advilad eguebian is qalebi, romelTac uwyveti samuSao biografia
aqvT. SesaZloa imitom, rom ukeT arian uzrunvelyofili finansurad da
materialurad da ukeT arian Seguebuli pensiaze gasvlasTan, vidre is
qalebi, romelTac xSirad hqondaT wyveta samuSao biografiaSi.

ojaxuri da piradi urTierTobebi.

xanSiSesuli adamianebisaTvis xSirad, udidesi siamovnebaa
SviliSvilebTan urTierToba. maTTan xSiri da mosiyvarule kontaqtebi
qmnis megobrul damokidebulebas. igive SeiZleba iTqvas didi bebiebisa da
babuebis Sesaxebac _ SvilTaSvilebi maT cxovrebas mravalferovnebas
aniWeben, siamayisa da ganaxlebis gancdas uCenen.

meuRlis dakargvasTan Segueba

xandazmul asakSi adamians SeiZleba dasWirdes daxmareba,
gansakuTrebiT avadmyofobis dros. rogorc wesi, movlis mTeli simZime
awveba meuRles, ufro xSirad cols, vidre qmars. gansakuTrebuli
sirTuleebi xvdeba maT, vinc uvlis alcheimeriT daavadebul adamians.
xandazmul asakSi ar aris gamonaklisi axlobeli adamianis,
megobris an meuRlis sikvdili, rac aCens mwuxarebis da danakargis
gancdas. bevrisTvis daqvriveba Zalian mZime gadasatani xdeba, radgan
icvleba cxovrebis stili da aris axloblebisgan izolirebis riskic.

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qalebisTvis daqvrivebis albaToba samjer metia mamakacebTan SedarebiT.
amasTan, xandazmuli qvrivi qalebi saSualod 50%-iT mets cxovroben
vidre amave asakis qvrivi mamakacebi.
marto mcxovrebi qvrivebi ejaxebian yofiT cxovrebaSi praqtikul
da fsiqologiur sirTuleebs. maT uxdebaT yvelafris TviTon gakeTeba:
yofiTi problemebis gadawyveta, socialuri kontaqtebis SenarCuneba,
finansuri sakiTxebis mogvareba. zogisTvis es SesaZloa seriozuli
problema iyos, radgan manamde am sakiTxebs meuRle agvarebda.
zogierTi kvlevis Tanaxmad, daqvriveba uaryofiTad moqmedebs
xandazmuli mSoblebisa da ukve mowifuli Svilebis urTierTobebze.
droTa ganmavlobaSi dedasa da Svilebs Soris urTierTobebi
umjobesdeba _ deda da Svilebi finansuradac ki exmarebian erTmaneTs.
mamasa da Svilebs Soris urTierTobebi arcTu iSviaTad uaresdeba dedis
sikvdilis Semdeg.
daqvrivebuli qalebi ukeT axerxeben socialuri kontaqtebis
SenarCunebas, xolo qvrivi mamakacebi ufro xSirad aRmoCndebian
izolaciaSi da kargaven im kontaqtebs, romelic qonda am wyvils. isini
aseve naklebad monawileoben socialur cxovrebaSi. holandiaSi
Catarebuli kvlevis Tanaxmad, romelSic monawileobda 3-5 wlis win
daqvrivebuli da Svilebisgan calke mcxovrebi qalebi da mamakacebi,
qvrivi mamakacebi Cveulebriv ufro mdidrebi arian da ufro
ganaTlebulic, ukeTesi janmrTeloba aqvT da meti Sansi axali
partnioris povnisTvis. Tumca, ufro mZimed gadaaqvT danakargi emociuri
TvalsazrisiT. gansakuTrebiT martosulad grZnoben Tavs uSvilo
qvrivebi.
ded-mamiSvilebi da megobrebi. gviani xandazmulobis periodSi
adamianebi xSirad aRniSnaven, rom imata interesma dedmamiSvilebis
cxovrebis mimarT, ufro mtkice xdeba maT Soris kontaqtebic. debi da
Zmebi zogjer erTad iwyeben cxovrebas, erTmaneTs anugeSeben da
mxardaWeras agrZnobineben mZime wuTebSi da avadmyofobisas.
dedmamiSvilebTan kavSirebis ganmtkiceba gansakuTrebiT mniSvnelovania,
maTTvis, visac Tavisi ojaxi ar aqvs an visac sakuTari Svilebi ar hyavs,
romlebic daexmarebian saWiroebis dros.
kvlevebis mixedviT, xanSiSesuli adamianebis umravlesoba naTesaur
urTierTobebs ganixilavs rogorc mudmiv mocemulobas. naTesavebs
SeiZleba mimarTo maSinac, Tu didi xniT gWirdeba daxmareba. magram ar
SeiZleba es moTxovo megobrebs. megobrebi dagexmarebian mZime wuTebSi,
magaliTad moulodneli avadmyofobisas, magram xangrZlivi
pasuxismgebloba aqvT mxolod naTesavebs.

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 asakovani adamianebis mimarT uaryofiTi stereotipis erT-erTi
Sedegia konkretuli crurwmena, romelsac asakis mixedviT diskriminacias
anu eijizms uwodeben. mas Tan sdevs xandazmulTa diskriminacia, rac
zRudavs maT SesaZleblobebs, axdens maT izolirebas da xels uwyobs
sakuTar Tavze uaryofiTi warmodgenis Seqmnas. zimbardos azriT, xSirad
fsiqologebi Tavad arian damnaSaveni aseTi diskriminaciis gavrcelebaSi
im terminologiis gamo, romelsac iyeneben. ukanaskneli 49 wlis
ganmavlobaSi dawerili 139 studenturi naSromis Seswavlam aCvena, rom
bevrma studentma arc ki CarTo kvlevaSi moxucebulobis periodi an
warmoadgina stereotipuli mosazrebebi xanSiSesul adamianebze. asakis
mixedviT diskriminaciis ufro STambeWdavi da naTeli magaliTia erT-
erTi Jurnalistis pet muris piradi gamocdileba, romelic
mizanmimarTulad, droebiT grimis daxmarebiT, 85 wlis "moxuc"
qalbatonad iqca. man Semoiara aSS-s 100-ze meti qalaqis quCebi imis
gasarkvevad, Tu ras niSnavda moxucebulad yofna amerikaSi. bundovanma
kontaqturma linzebma da yuris sacobebma mas mxedveloba da smena
gauuaresa; erTmaneTze gadabmuli fexebiT siaruli uWirda; misi TiTebi
ki daxveuli webovani lentis gamo arTritian TiTebze odnav moqnili iyo.
es "patara moxuci qali" gadarCenisaTvis ibrZoda Zlieri da sicocxliT
savse axalgazrdebisTvis Seqmnil samyaroSi. mas ar SeeZlo qilis gaxsna,
saweri kalmis xelSi daWera, warwerebis wakiTxva, avtobusis kibeze
asvla, mas siswrafis, xmaurisa da Crdilebis samyaro aSinebda. rodesac
daxmareba sWirdeboda, iSviaTad Tu gauwodebda vinme xels, xSirad
dascinodnen moxucebulobisa da mowyvladobis gamo; igi mozardTa
jgufis sastiki Tavdasxmis msxverplic ki gaxda.
muris gamocdileba amtkicebs azrs, rom sazogadoeba rogorc
fizikuri, ise _ socialuri TvalsazrisiT, xandazmulobis winaaRmdeg
aris mimarTuli. Zaladoba moxucebze ar aris iSviaTi movlena.
asakobrivi segregacia da siRaribe aris dRes xandazmulobis periodis
mTavari problemebi. xandazmulTa movla specializirebul
dawesebulebSi xSirad araa damakamayofilebeli. alternatiuli variantia
xandazmulTaTvis dRis centrebis, sacxovrebeli centrebis, samedicino
ganyofilebebis organizeba, sxvadasxva saxis satransporto momsaxureba,
invalidebis movla da sakvebis mitana saxlSi. xanSisesul adamianebsac
SeuZliaT erTmaneTis daxmareba sazogadoebrivi organizaciebis
xelSewyobiT.

siberisaTvis mzadeba
Tuki Cvens cxovrebas ganviTarebis tendencia da
TviTrealizebisaken swrafva axasiaTebs, maSin sibere udavod, cxovrebis
mizania. ar varga iseT statikur mdgomareobaSi yofna, mxolod warsulis

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realizacias rom iTvaliswinebs, rac janmrTelobis nebismier fasad
SenarCunebisaken swrafvaSi gamoixateba. es swrafva zog SemTxvevaSi
groteskul xasiaTs iRebs, TviTmizani xdeba da cxovrebis erTaderT
sazrisad iqceva. rac ufro metad cdilobs adamiani cxovrebaSi “Tavis
Senaxvas”, sul ufro dominanturi xdeba erTaderTi sazrunavi: imis
SenarCuneba, rac TandaTan xelidan usxlteba. zogierTi moxucisaTvis
TviTgadarCenis instiqti TviTkmari xdeba - moxuci xSirad gamwarebiT
ebRauWeba sicocxles maSinac ki, rodesac am sicocxles fasi aRarc aqvs.
sibereSi damafiqrebel problemas warmoadgens TviTmkvlelobis
riskic. ukanaskneli statistikuri monacemebiT, es riski siberes
mitanebul da moxucebul adamianebSi yvelaze ufro maRalia. Tu
axalgazrdobasa da Sua asakSi konfliqtebi Warbobs, moxucebulobaSi
simartoviT gamowveuli TviTmkvlevlobis albaToba matulobs. simartove
gansakuTrebiT Trgunavs mamakacebs; qalebi ukeT umklavdebian mas da
saSvelsac ufro advilad pouloben. TviTmkvlelobis kidev erTi mizezia
sibereSi dauZlurebisa da sxvaze damokidebulebis SiSi, rasac imaze
fiqri amZafrebs, rom bevri adamiani eWviT uyurebs moxucebulTa
TavSesafrebs da iq cxovrebisagan kargs arafers elis.
is, rac SeiZleba cxovrebaSi moulodnelad Tavs dagvatydes,
sibereSi asmagad ufro Rrma Wrilobas gvayenebs,. radganac
garkveulwilad Segvwevs momavlis Wvretis unari, SegviZlia momzadebuli
SevxvdeT mraval iseT problemas, romlebzec cxovrebiseuli
gamocdileba migvaniSnebs. magram rogor unda moxdes es momzadeba?
upirveles yovlisa, Cndeba survili siberisaTvis materialuri
TvalsazrisiT movemzadoT, Tumca es dResdReobiT yvelaze did SiSsa da
moulodnelobasTanaa dakavSirebuli. dRes, rodesac sazogadoebrivi
fondebi dacarielebulia da pirovnebas mxolod sakuTari Tavis imedi
unda hqondes, safrTxe daemuqra ara mxolod uzrunvel siberes, aramed
zogadad janmrTelobis dacvasac, metadre socialurad daucveli
fenebisaTvis.
adamians sul ufro uWirs siberesTan sakuTari ZalebiT brZola;
zogierTi sportiTa da dietiT cdilobs Tavidan aicilos zedmeti wona.
magram siberesa da mis gauTvaliswinebel SedegebTan brZolis CvenTvis
misawvdomi saSualebebi amiT TiTqmis mTlianad amoiwureba.
saerTod ras niSnavs siberisaTvis mzadeba? es saukeTesod Cans im
adamianebis magaliTze, romlebic siberes moumzadebelni Sexvdnen.
ai, diasaxlisi da ojaxis deda, romelic mTlianad Caflulia
yoveldRiur sazrunavSi da sxva veRarafrisaTvis iclis. yovel
SemTxvevaSi, is Tavis cxovrebas swored ase xedavs: Tvalwin mxolod
uSualod momdevno dRis saojaxo saqmeebi udgas da cdilobs maT
keTilsindisierad gaarTvas Tavi. mere ki “uecrad” Svilebi ezrdebian da

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saxlidan midian. meuRle mTeli dRis ganmavlobaSi samsaxurSia. binis
dalagebasa da sxva saqmeebs didi dro aRar miaqvs. amis Semdeg ki
sicariele isadgurebs. diasaxlisma aRar icis ra akeTos, ra unda qnas
rodesac movaleobebi Seumcirda, uamravi Tavisufali dro gauCnda da
sruliad axal situaciaSi aRmoCnda?
visac aseTi ram moumzadeblad atydeba Tavs, xSirad
sasowarkveTilebasa da depresiaSi vardeba. marTalia, Cveni epoqa
garkveul saSualebebs gvTavazobs (televizia, kino da a.S.), magram es
yovelive pirovnebis iniciativasa da aqtivobas ar moiTxovs da pasiur
garTobas niSnavs, ris gamoc arasakmarisia. zogierTi amas sjerdeba,
magram bevrs es ar akmayofilebs da amitomac gamudmebiT natrobs netav
adre mefiqra, netav iseT rameze mezruna, rac axla sicarieles
amomivsebda da sixaruls momaniWebda.
problemac swored esaa: metismetad didxans vcxovrobT mxolod
awmyoTi da momavali srulebiT ar gvadardebs. amitomac siberisaTvis
mzadebis umoklesi formula aseTia: droulad CavrToT sibere Cvens
samomavlo gegmebSi, raTa erT mSvenier dRes umweoni ar aRmovCndeT
sicarielis winaSe.
moulodnelad Tavs datexil siberesTan erTad, rogorc wesi, sxva,
kidev ufro mZime problemebic iCens Tavs. mSobels uWirs SvilebTan
ganSoreba, ar aclis sakuTari cxovrebiT icxovron, radgan isini jerac
TviTon Wirdeba, Tumca cdilobs es CabRauWeba dedobrivi siyvaruliTa
da mzrunvelobiT gaamarTlos. igi ise iqceva, rom Svilebs danaSaulis
gancda uCndebaT, rodesac mSobels marto stoveben. deda Tavisi
umweobisa da sasowarkveTilobis demonstrirebas axdens, avadac ki xdeba,
raTa Svilebi miijaWvos, daarwmunos, rom maTi zrunva esaWiroeba da
marto darCena daRupavs. am niadagze araerTi ojaxuri tragedia
gaTamaSebula. mravali vaJiSvili Tu qaliSvili Seswirvia mSoblis
amgvar “siyvaruls”. Sedegad Svilebi mtkice urTierTobas veravisTan
amyareben, sakuTari yofiT cxovrebas ver bedaven, radgan mSoblis
sayveduri Tu mowyobili scenebi danaSaulis iseT mZime gancdas
uRviveben, rom sakuTar cxovrebaze uaris Tqmas amjobineben. xSir
SemTxvevaSi amas Svilis xasiaTis sisustec emateba. amasTan, uyuradRebod
ver darCeba is udidesi zegavlena, rasac Svilze mSoblisgan momdinare
molodini axdens – madlierebisa da valis moxdis molodini,
gamudmebuli gancda imisa, rom mSoblis winaSe didi vali akisria.
magram ZaldatanebiT gaRebuli msxverpli, adre Tu gvian, cudi
mxriT Semogvibrundeba. am viTarebaSi Svili iZulebuli xdeba mSoblis
gardacvalebas daelodos, raTa tvirTisagan ganTavisufldes. tvirTad ki
eqca gamudmebuli Sexseneba, Tu ramdeni ram gaakeTa misTvis mSobelma, ra
msxverplze wavida (Tumca Svils es msxverpli sulac ar mouTxovia).

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mSoblis sikvdilis natvra Svils danaSaulis gancdas uqmnis da
aiZulebs uwindelze meti zrunva da yuradReba gamoiCinos. sxvagvarad
maT Soris SeiZleba aSkara siZulvilic gaCndes. amgvarad ikvreba wre,
romlis darRvevac SeuZlebeli Cans da xSirad adamiani xsnas
avadmyofobaSi anda nevrozSi eZebs.
amgvarad, Tu mSobeli siberes moumzadebeli xvdeba, is SeiZleba
gausaZlis tvirTad daawves Svils. dRes, roca ojaxuri kavSirebi
irRveva, amgvari SemTxvevebis raodenoba SeiZleba Semcirdes kidec. am
rRvevis agresiuli formebi swored imis Sedegia, rom mSoblebi
metismetad aqtiurad warudgenen Svilebs Tavis pretenziebs. jer kidev
Zalian bevria iseTi mSobeli, romelTac bunebrivad miaCniaT, rom
sibereSi Svilebma maTze unda izrunon. rodesac es avadmyofobis Tu sxva
mizezis gamo marTlac aucilebelia, amas Svilebic xedaven da metwilad
mzad arian es movaleoba itvirTon. mSoblebis nevrozisa da
“moumwifeblobis” gamo Svili mSoblad iqceva da mSobeli – Svilad.
yvelaze mZime mdgomareobaSi eqcevian dediserTa da daqvrivebuli Tu
gayrili mSoblebis Svilebi. rodesac mSobeli kvdeba, Svili Cveulebriv,
Sua asaksaa mitanebuli ise, rom sakuTari cxovrebiT ar ucxovria. bevri
ram ukve dagvianebulia, bevri ramis gamosworeba SeuZlebelia da
adamians sasowarkveTileba ipyrobs; is avad xdeba anda sazogadoebisagan
gariyuli, uRimRamo aCrdiliviT cxovrobs, romelsac yvelani Tavs
arideben, radgan masSi daukmayofileblobasa da danaklisis anazRaurebis
xarb wyurvils xedaven.
kidev erTi magaliTi: mamakaci, romelsac samuSaos garda araferi
ainteresebs da cxovrebaSi mxolod imas aRiqvams, rac ama Tu im saxiT
mis saqmianobas ukavSirdeba; misTvis sxva araferi arsebobs. amgvari
calmxrioba nebismier profesiaSi SeiZleba didi warmatebis sawindari
gaxdes, magram amave dros, es adamianis Tvalsawiers Zalian amcirebs.
profesiuli codna sinamdvilis erT aspeqtze koncentrirebas iTxovs,
rasac zogadi, farTo xedva ewireba. zogierTi gangeb STaagonebs sakuTar
Tavs, rom Tavisi specialobis garda araferi ainteresebs, raTa
yuradReba ar daefantos da saqmeSi xeli ar SeeSalos. magram adamianuri
saqmianobis arcerTi sfero ar aris samyarosagan imdenad mowyvetili,
rom gverdze gaxedvis saSualebas ar iZleodes. adamiani maSin unda
eswrafodes Tvalsawieris gafarToebas, rodesac Tavis viwro
specialobaSi ukve daostatda da garkveul Sedegebsac miaRwia.
moucleloba xSirad Tavis gasamarTlebeli sababia, romelic Cveuli,
gakvaluli gzidan gadaxvevis SiSis gamomxatvelia. amgvari Caketiloba
naadrevad gvaberebs, radgan mravali iseTi unaris ganviTarebas uSlis
xels, rac Cveni cxovrebis nawilia.

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 roca msgavs viTarebaSi ama Tu im mizeziT SeuZlebeli xdeba Cveuli
saqmianobis gagrZeleba, Cndeba sicariele, umweoba, miusafroba. Sedegad
adamiani Zalze xSirad borotdeba, iwyebs smas, grZnobs, rom cxovrebas
CamorCa da javrs ojaxis wevrebze iyris; is Tavs veRar akontrolebs da
arcTu iSviaTad uxasiaTo, kacTmoZule moxucad yalibdeba.
msgavsi magaliTebi ar aris iSviaTi. Sua asakSi aucilebelia
sakuTar Tavs davusvaT kiTxva: rogor unda vicxovro mas Semdeg, rac
Svilebi gaizrdebian da saxls datoveben, Tan profesiuli saqmianobis
mowyveta momiwevs? arasodesaa naadrevi imaze fiqri, Tu ra vakeToT
momavalSi, raTa sxvebis Tanadgomasa Tu yuradRebaze ar viyoT
damokidebuli. cxadia ioli ar aris, gagvifrinden Svilebi, romlebsac
amdeni siTbo, zrunva da siyvaruli SevalieT, magram es Cveni arsebobis
wesia da ufleba ara gvaqvs isini madlierebis valdebulebiT samudamod
mivijaWvoT. Svilebis gaSveba siberisaTvis pirveli Semzadebaa, rasac
kidev bevr ramesTan Seleva unda mohyves.
sibereSi vinmesTan an ramesTan Selevis unari winandelze met
mniSvnelobas iZens. cxovrebis swored am etapze SevigrZnobT raoden
saWiroa es unari.
unda aRiniSnos siberis kidev erTi konstruqtiuli aspeqti –
SemoqmedebiTi saqmianobis nebismieri forma, rac adamians SeaZlebinebs
sakuTari ZalebiT “aSenos” Tavisi sibere da mas sasurveli saxe mianiWos.
cxadia esec TandaTanobiT unda momzaddes. ar unda velodoT, rom
adamians erTbaSad axali niWi Tu unari aRmoaCndeba, risTvisac winaT
yuradReba ar miuqcevia. zogierT iRblians saSualeba eZleva Rrma
moxucebulobamde ganagrZos profesiuli saqmianoba. eseni arian:
mecnierebi, xelovanni, politikosebi, eqimebi an Tundac fsiqoTerapevtebi.
zogierTi maTgani swored moxucebulobaSi aRwevs srulyofilebas
sayvarel saqmeSi. Cveulebriv, adamians aqvs aTasnairi niWi Tu unari,
romlis amoqmedebac ZaluZs, Tuki im warmodgenisagan gavaTavisuflebT,
TiTqos mxolod “saWiro” sagnebs hqondes arsebobis ufleba. Tuki keTebis
sixaruls mivendobiT da Cveni siamovnebisTvis viSromebT, maSin sakuTar
TavSi bevr axals aRmovaCenT. profesiis arCevani interesebis
gansazRvrul sferosTan gvakavSirebs da erTgvarad gvboWavs, asakSi
Sesvlisas ki SegviZlia Tavs ufleba mivceT iseTi dargebic movsinjoT,
mudam rom gvainteresebda da gvizidavda, magram saamiso SesaZlebloba ar
gveZleoda. amasTan, mTavari is ki ar aris raRac mniSvnelovani SevqmnaT,
aramed is, rom am saqmianobam sixaruli mogvaniWos. SesaZlebelia axalma
saqmem Tu garTobam swored Tavisi umiznobis wyalobiT ufro metadac
gagvaxalisos, vgulisxmobT TviTgamoxatvis nebismier saSualebas: xatvas,
Wras, musikas, Tu raime dekoratiul xelobas.

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 moxucebulobaSi amgvari saqmianobis xibli swored isaa, rom
Sedegze orientirebuli ar varT – amiT arc fulis gamomuSavebas
vcdilobT, arc pativmoyvareobis dakmayofilebas, iqneb saerTodac
araviTar konkretul mizans ar visaxavT. samagierod sakuTar TavSi iseT
Tvisebebs vpoulobT, rasac manamde ver vamCnevdiT; es sicocxlis xaliss
gvinarCunebs da moxucebisaTvis damaxasiaTebeli nihilizmisagan
gvifaravs. yvelafris uaryofa da umoZraoba myisierad gvaberebs, radgan
amiT Cveni TavisaTvis TviTonve gamogvaqvs ganaCeni. Sedegad adamiani
uaryofs da eWvis TvaliT umzers yvelafer axals, radgan cxovrebis
siaxleebSi monawileobaze TviTonve ambobs uars, sabolood ki
sasowarkveTileba ipyrobs.

ra gvirTulebs dResdReobiT daberebas

dRevandelze ufro mSvid da auCqarebel epoqebSi dabereba
gacilebiT advili iyo. moxuci sagangebo mowonebas imsaxurebda, radgan
Tuki naadrevad ar dauZlurdeboda, Tavisi codnisa da gamocdilebis
xarjze mas axalgazrdasTan SedarebiT didi upiratesoba hqonda.
tradiciul ojaxSi moxucs sakuTari funqcia hqonda. didi ojaxis
daSlisa da industrializaciis Sedegad viTareba Seicvala – moxucebi
ufunqciod darCnen, metic, zedmet da Semawuxebel tvirTad iqcnen. maT
moxucebulTa TavSesafrebSi amwyvdeven da ojaxis nacvlad iq an
saavadmyofoebSi ixocebian. moxucTa gasaWirisa da ubedurebis dramebi
sazogadoebis miRma TamaSdeba, radgan maTi problemebisadmi aravin
TiTqmis araviTar interess ar iCens.
winaT moxucebs axalgazrdebze meti gamocdileba hqondaT. iSviaT
SemTxvevaSi isic SegveZlo gveTqva, rom moxucs is axasiaTebs rasac Cven
simwifes vuwodebT – esaa rTulad gansasazRvri Tviseba, rasac adamiani
Sinagani ganviTarebis garkveuli etapis miRwevisas iZens da maSinve
TvalSi gvecema. es garemoeba moxucs axloblebis wreSi gansakuTrebul
pativiscemas sZenda. Rirseuli siberis molodinSi zogierTs Tavisi
cxovrebis daisi idiliis saxiT warmoedgina, rogorsac winaT
romantikul suraTebze gamosaxavden xolme. sxvebi imedovnebdnen rom
sikvdilamde SeinarCunebdnen avtoritets; marTalia ukana planze
gadainacvlebden, mainc ojaxis umaRles instanciad darCebodnen da maT
gareSe axalgazrdebi mniSvnelovan gadawyvetilebebs verasodes
miiRebdnen. iyvnen iseTebic, visac mtkiced swamda, rom maT gareSe
veranair saqmes Tavi ver moebmeboda. amitomac droulad gadadgomas ar
apirebdnen da sakuTar Tavsac da sxvebsac umtkicebdnen, rom jerac ar
daberebulan. Tumca umravlesoba ise moeloda siberes, rogorc sibrZniT,
pativiTa da madlierebiT mosil asaks, da darwmunebuli iyo, rom am
yovelives wlebis matebis gamo imsaxurebda.

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 siberis aseTi gaidealeba dRes warsuls Cabarda, Tuki odesme
marTlac Seesabameboda sinamdviles. idiliuri suraTi – savarZelSi
mjdomi, keTilad momRimari Cibuxiani papa da qsoviT garTuli bebia,
romelTac gars axvevia madlieri Svilebi da mowiwebiT aRvsili
SviliSvilebi – mTlianad Secvala “axalgazrdad darCenili moxucis”
xatma. magram miuxedavad Tanamedrove cxovrebisaTvis fexis ayolis
survilisa, balansi bevrisaTvis ulmobelia; tkivili, avadmyofoba,
imedgacrueba; boRma, simartove, zedmetobis gancda; konfliqti ojaxTan
Tu axalgazrda TaobasTan; CixSi momwyvdeuloba. siberesTan
dakavSirebul sentimentalur-idealizebul molodins dRemde imaSi
miuZRvis brali, rom siberisaTvis saTanadod ar vemzadebiT, mas
pretenziebs vuyenebT, xolo rodesac es pretenziebi ar marTldeba,
vSfoTavT, vborotdebiT da axalgazrdobisadmi siZulviliT
vimsWvalebiT, radgan is Cvens molodins ar amarTlebs. imis molodini,
Tu rogor mopyrobas vimsaxurebT sibereSi, xels gviSlis mzad SevxvdeT
siberis moaxloebas. ufrosi Taobis warmomadgeneli xSirad jiutad
xuWavs Tvals imaze, rom axalgazrdobas Tavisi sazrunavi problemebi da
survilebi aqvs da sulac ar surs sxvisi Careva anda mxolod gonivrul
rCevas moiTxovs. magram wina Taobas xSirad aRar ZaluZs sasargeblo
rCevis micema, radgan samyaro uswrafesad icvleba da sul ufro
rTuldeba!
sibereSi Sesuli adamiani dRes iseTi problemebis winaSe dgas, rac
winaT misTvis ar arsebobda: sul ufro xSirad irkveva, rom sibere
aucileblad sibrZnesa da gamocdilebas sulac ar niSnavs. ufros Taobas
xelSemSlelad evlineba adre SeZenili Cveva Tu konkretuli informacia,
xSirad gamocdilebac ki boWavs da axlis gageba-Seswavlas urTulebs.
wina epoqebTan SedarebiT es sruliad axali viTareba bevr moxucs
aSinebs da Tavgzas ubnevs, radgan imasTan Segueba uwevs, rom
axalgazrdebi sul ufro bevr rameSi jabnian – magaliTad, kompiuteris,
mobiluri telefonis an kameris gamoyeneba. amrigad, bevr sferoSi
gauqmda ostatobis cneba, romelic winaT asakovansa da gamocdil
pirovnebas gansakuTrebul statuss aniWebda. amis gamo dRes adamiani
xSirad uwindelze adre grZnobs siberis moaxloebas da
axalgazrdebisagan CamorCenas mtkivneulad ganicdis.
dRes daberebis problema imitomac garTulda, rom zogadad
axalgazrdobas da kerZod umcros Taobas yvelaferSi upiratesoba
mieniWa. reklama mxolod axalgazrda da lamaz adamianebs warmogvidgens,
sinorCis kulti sxva yvelafers ukana planze ayenebs. sibere da simwife
lamis samarcxvinod iqces. es kidev ufro mZafrad ganacdevinebs
xandazmul adamians raRac aunazRaurebel danakargs, ubiZgebs sinanuliT
miubrundes warsuls, an yvela Rone ixmaros raTa ufro didi xniT

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SeinarCunos Tundac garegnuli axalgazrdoba. aseT SemTxvevaSi adamians
mTeli yuradReba imaze gadaaqvs, rac aRar SeuZlia da aRara aqvs da
sruliad ugulvebelyofs imas, rac jer kidev mis xelTaa.
vinc mxolod danakargsa da klebas xedavs, vinc warsulsa da
awmyos gamalebiT ebRauWeba, misTvis momavali kategoriulad miuRebelia...
arada swored droSi SezRudulobis gaazreba aniWebs siberes sicocxlis
specifikur gancdas, uqmnis axal SesaZleblobebs. magram am unaris
daufleba swavlas moiTxovs. siberis zRvarmitanebul adamians mudam aqvs
arCevani – imis SenarCunebas ecados, rac xelidan usxlteba, Tu
cxovrebis axal gancdas miendos da amiT axali SesaZleblobebisa da
gardasaxvebisaTvis moemzados.
Tu sibere mxolod uaryofiT movlenad aRiqmeba, gasakviri sulac
araa, rom adamianebi mas ebrZvian. upirveles yovlisa ki samedicino
saSualebebiT. propaganda imdenad didia rom adamianebi am saswaulebrivi
saSualebebis imediT suldgmuloben da pasiuri molodinis amara rCebian.
es maT sakuTar iniciativasa da SemoqmedebiT unars usustebT, radgan
mTeli yuradReba sxeulis problemebze gadaaqvT.
xandazmulma mxolod danakargze ki ar unda ifiqros, aramed
momavalsac Seavlos Tvali da am momavlis farglebSi Tavisi
aRsasrulic gaiTvaliswinos.

ra gviadvilebs daberebas

cxovrebaSi arafers aqvs mxolod uaryofiTi an mxolod dadebiTi

aspeqti.

Tanamedrove medicina siberis dasaZlevad sul ufro met saSualebas

gvTavazobs. manamde ganukurneblad miCneuli mravali daavadeba dRes, Tu
ar ikurneba, naklebmtanjveli mainc gaxda; maT Soris bevri swored
siberis daavadebaa.

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 მონტალჩინის რჩევები

35 რჩევა ქალისგან, რომელმაც 100 წლის შეუფასებელი ცხოვრებისეული გამოცდილება აქვს:

1. თუ გაბრაზებული ხარ ან ზიზღის გრძნობით შეპრყობილი, შეეცადე, გათავისუფლდეთ ამისგან.

2. ყოველთვის გიყვარდეს და გჯეროდეს სიყვარულის.

3. ყველაფერი, ყოველთვის უკეთესობისთვის ხდება. ღმერთი მოწყალეა და არ მიგატოვებს.

4. ცხოვრებაში ყველაფერი მხოლოდ შენზეა დამოკიდებული.

5. დროა სიცილის და დროა ტირილის.

6. იმოგზაურე, სანამ ახალგაზრდა ხარ და საშუალება გაქვს. ნუ დაინანებ ფულს. დაიმახსოვრე,

გამოცდილება ბევრად ფასეულია, ვიდრე ფული.

7. ჩვენს განკარგულებაში ყოველთვის არის ხვალ.

8. არ შეადარო! შენ არასოდეს იქნები აღფრთოვანებული საკუთარი ცხოვრებით. ღობის იქით

მინდორი ყოველთვის უფრო მწვანე გეჩვენება.

9. თუ ვინმესთან არ გსურს ურთიერთობა, გაწყვიტე კავშირი. შენ არ ხარ არავისთნ ვალდებული.

10. ყოველდღე აკეთე ის, რაზეც დიდი ხანია ოცნებობდი.

11. ერთადერთი უცვლელი რამ ჩვენს სამყაროში არის ის, რომ ირგვლივ ყველაფერი იცვლება.
შეეცადე, გააცნობიერო ეს და მიიღო.

12. ნუ ინანებ შეცდომებს.

13. ნუ იქნები უხეში.

14. იზრუნე მხოლოდ იმაზე, რა იქნება შენთვის მნიშვნელოვანი საბოლოოდ.

15. აპატიე.

16. იყავი გულწრფელი საკუთარ თავთან და გარშემომყოფებთან.

17. სხვა ადამიანებთან ურთიერთობა – ყველაზე მნიშვნელოვანი ნაწილია ჩვენი ცხოვრების.

განსაკუთარებით მაშინ, თუ ამ ადამიანთან მთელი ცხოვრება უნდა გაატარო ქორწინებაში.

18. იპოვე ის, რაც მართლა მოგწონს და აკეთე ეს საქმე.

19. ნურც შეეცდები გაიგო ყველაფერი, რაც შენს ირგვლივ ხდება.

105
20. ყველაფერი ადრე თუ გვიან საკუთარ ადგილზე დგება.

21. ამბობენ, რომ მშობლებს შენ ვერ აირჩევ. ტყუილია!

22. მიიღე სიამოვნება შენი სამუშაოსგან.

23. არ მიიღო არანაირი ვიტამინი. მიიღე ისინი ბუნებრივი გზით.

24. დაკავდი ფიზკულტურით. უბრალოდ გადი გარეთ და ისეირნე. ეს ძალიან მნიშვნელოვანია.

25. ერთ მშვენიერ დღეს შენ მიხვდები, რომ მთელი შენი ცხოვრება მხოლოდ იმას აკეთებდი, რომ
უმნიშვნელო რაღაცებზე ნერვიულობდი.

26. ჩვენი ცხოვრება – მოზაიკაა. ის ეწყობა წვრილმანებისგან, რომლებიც ქმნიან მნიშვნელოვან არსს.

27. ნუ მიიღებ ცხოვრებას ზედმეტი სერიოზულობით.

28. დაიმახსოვრე, სიყვარული არ ტეხს გულებს. ამ შემთხვევაში ეს სიყვარული არ არის!

29. უკან მოხედვასაც ვერ მოასწრებ, ისე ჩაივლის ცხოვრება შენს მიღმა.

30. ბევრი რამ სინამდვილეში ისეთი არ არის, როგორიც ჩვენ gვეჩვენება.

31. ისწავლე შეგუება. ადამიანს ბევრი რამის გადატანა შეუძლია.

32. მადლობელი იყავი მშობლების ყველაფრისთვის, რაც მათ შენთვის გააკეთეს.

33. გამონახე დრო გამოიტირო ის, რაც დაკარგე.

34. იყოლიე შინაური ცხოველი. დროდადრო შეიძლება მარტო იგრძნო თავი. შინაური ცხოველი
ყოველთვის შეგახსენებს, რომ ყველა ჩვენგანი სულიერია. ჩემი აზრით, ცხოველებსაც აქვთ სული.

35. არ გარწმუნებ იმაში, რომ უნდა მისდიო ან არ მისდიო რომელიმე რელიგიას, მაგრამ ვალდებული
ხარ, იპოვო ის, რისიც გწამს და იცხოვრო შენი რწმენის მიხედვით.

იცხოვრე სიამოვნებით და მთელი დატვირთვით!

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თემა 5. ცხოვრების დასასრული

sicocxlis dasasruli: fiqrebi sikvdilis Sesaxeb da sikvdilis miReba

sikvdili aris bolo kritikuli movlena adamianis cxovrebaSi.

fiziologiur doneze sikvdili warmoadgens yvela sasicocxlo funqciis
Seuqcevadad Sewyvetas. xolo fsiqologiur doneze mas mniSvneloba aqvs
piradad momakvdavisa da misi axloblebisTvis. mokvde, niSnavs rom veRar
grZnob, toveb axloblebs, daumTavrebel saqmeebs da gadadixar
usasrulobaSi. magram sikvdili kulturis mniSvnelovani komponenticaa.
is aisaxeba literaturaSi, xelovnebaSi, musikaSi, religiasa da
kulturis filosofiaSi da gansaxierdeba ritualebsa da wes-CveulebebSi.
dabadeba da sikvdili bunebrivi movlenebia, magram maTi emociuri
gavlena da pirovnuli Rirebuleba mniSvnelovnad gansxvavdeba. adamianis
dabadebas elian sasiamovno mRelvarebiT da optimizmiT; sikvdilze fiqrs
ki adamianebi gaurbian da uaryofen kidec.
“sikvdilTan erTad cxovreba”, anu aRsasrulisaTvis mzadyofna
siberis erTerTi zogadi maxasiaTebelia.

zogadad dasavluri kulturisaTvis sikvdilis, rac SeiZleba, didxans

uaryofaa damaxasiaTebeli. vcdilobT aRsasrulze Tvali davxuWoT, masze
fiqrs veridoT. amiT sikvdilis aracnobier SiSs viormagebT, anu,
faqtobrivad, sasurvelis sapirispiro Sedegs viRebT. rodesac moxuci da
avadmyofi adamiani sikvdilze laparakobs, axloblebi cdiloben, saubari
sxva Temaze gadaitanon da es fiqri gauqarwylon, rac gulwrfel
urTierTobas uSlis xels da sxvadasxvagvar proeqcias warmoSobs.
avadmyofi xvdeba, rom raRacas umalaven, sinamdvileSi ufro cudadaa,
vidre hgonia; axloblebi ki SiSoben, vaiTu simarTles mixvdeso da kidev
ufro TvalTmaqcoben.
marTalia ar arsebobs qcevis sayovelTaod miRebuli standartebi,
magram unda daisvas kiTxva: iqneb moxucebulisaTvis umjobesi iyos, Tu
mas axloblebTan Tavisi sikvdilis Sesaxeb mSvidad saubari SeeZleba.
rac ufro metad eridebian amas adamianebi, miT ufro rTuldeba maT
Soris urTierToba. moxuci mxolod maSinaa mSvidad, rodesac misi
sikvdili, piradad mis garda, sxvas aravis exeba. ra Tqma unda, aq
gadamwyvet rols misi partniorTan urTierToba TamaSobs, Tumca arc aqa
gvaqvs qcevis zogadad miRebuli wesi. gansakuTrebiT eqims uWirs
avadmyofis mimarT swori poziciis dakaveba _ zogierTs surs sakuTari
mdgomareobis Sesaxeb simarTle icodes, sxvas ki nugeSiscema sWirdeba da

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zogjer Tavis motyuebac ki urCevnia; maS visa aqvs ufleba gadawyvitos
Tu rogori poziciaa misaRebi?

sikvdilis uaryofa
rodesac adamiani kvdeba, axloblebs aramarto ar surT masTan
amaze saubari, aramed TviTon momakvdavsac ukrZalaven amas. adre adamiani,
Cveulebriv, kvdeboda saxlSi, ojaxis wevrebis zrunviT garemoculi. aqve
sruldeboda tradiciuli ritualebi da wes-Cveulebebi. XX saukunis
Semdeg mdgomareoba ramdenadme Seicvala. adamianTa sul ufro meti
raodenoba kvdeba saavadmyofoSi da maTze samedicino personali zrunavs.
uaryofam SeiZleba xeli SeuSalos stresis aqtiur daZlevas.
sikvdilisTvis aqtiurad winaaRmdegobis gawevas.

sikvdilis mniSvneloba.
xandazmul asakSi, samwuxarod, iSviaTi araa naTesavis, megobris an
meuRlis sikvdili. mwuxarebis gancda gansakuTrebiT mwvavea meuRlis
dakargvis dros. reaqcia sayvareli adamianis sikvdilze ganxvavdeba
pirovnebis, asakis, sqesis, kulturuli tradiciebisa da
gardacvlilisadmi damokidebulebis mixedviT. moaruli Sexeduleba, rom
mwuxarebisa da emociebis aqtiurad gamoxatva xels uwyobs am
mdgomareobidan gamosvlas, simarTles ar unda Seesabamebodes. zogi
mecnieris azriT, axlobeli adamianis sikvdilze pirveli reaqcia aris
Soki _ faza, romelic xSirad ramdenime dRe grZeldeba, zogjer ki
gacilebiT metic. adamianis moulodneli sikvdilis SemTxvevaSi
axloblebi SesaZloa srulad ver acnobierebdnen danakargs da
gaognebuli iyvnen momxdariT. meore fazaze SesaZloa mwuxareba ufro
aqtiurad gamoixatos (tirili, moTqma). Cndeba tanjvisa da monatrebis
gancda. zogjer SeiniSneba sisuste, uZiloba, umadoba, interesis dakargva,
SeiZleba gamovlindes depresiis niSnebic. droTa ganmavlobaSi TandaTan
xdeba axal garemoebebTan Segueba. marto mcxovreb qvrivebs xSirad
uCndebaT praqtikuli da fsiqologiuri siZneleebi (yofiTi problemebis
mogvareba, socialuri kontaqtebis SenarCuneba dasxv.). maT mxardaWeras
cdiloben naTesavebi, megobrebi, magram yvelaze didi wili mainc
Svilebze modis. yvelaze martosulad Tavs uSvilo qvrivi qalebi
grZnoben.

moxucebis da ukurnebeli seniT Sepyrobili adamianebis

damokidebuleba sikvdilisadmi ramdenime stadias gaivlis:

• uaryofis stadiaze adamians ar unda aRiaros, rom SeiZleba mokvdes

da eZebs sxva, imedis momcem argumentebs da diagnozebs.

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• roca acnobierebs, rom marTla kvdeba, mas eufleba brazi, wyena da
Suri sxva adamianebis mimarT ("ratom me?") _ es aris risxvis stadia.

• vaWrobis stadiaze adamiani eZebs saSualebebs, rom gaixangrZlivos

sicocxle, Seimsubuqos tkivili da tanjva. mzadaa dados piroba da
SeTanxmeba RmerTTan, eqimTan, sxva adamianTan.

• Semdeg adamians SeiZleba daeuflos uimedobis gancda. dgeba depresiis

stadia. momakvdavi wuxs, rom uxdeba ganSoreba axloblebTan.

• miRebis stadiaze adamiani emorCileba beds da mSvidad elis

aRsasruls.

moaxloebulma sikvdilma SeiZleba aiZulos adamiani gadaxedos

Tavis cxovrebas, gansazRvros ra aris misTvis mniSvnelovani, ras
warmoadgens is sinamdvileSi. roca adamians SeuZlia Tavis Tavs uTxras:
"me kmayofili var" _ sikvdilis mas aRar eSinia. aseTi adamianebi Tavisi
cxovrebis gagrZelebas STamomavlebSi da sakuTar namoRvawarSi xedaven.
eriksoni maT ego-integrirebulTa kategorias miakuTvnebda. Tumca aris
adamianTa meore kategoria, romlebisTvisac cxovreba mxolod
ararealizebuli SesaZleblobebisa da Secdomebis Tanmimdevrobaa.
cxovrebis bolos isini acnobiereben, rom gviania yvelafris Tavidan
dawyeba. ego-integraciis ar arseboba (an nakleboba) maTSi aCens
sikvdilis SiSs, gamudmebuli uiRblobisa da sinanulis gancdas. isini
wuxan imaze "rac SeiZleba moxdes?!" da axdenen sakuTari naklis
proecirebas gare samyaroze.

Как общаться с пожилыми родителями и при этом не сойти с ума

самому?
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«Рост продолжительности жизни имеет вот какое последствие, о которым сразу и не
подумаешь. Теперь отношения детей с родителями продолжаются куда дольше, чем раньше.

Общение совсем взрослых детей с очень-очень взрослыми родителями — это своего рода
социальная терра инкогнита. Как правильно общение строить, чего требовать от родителей,
чего не требовать, как им помогать, не помогать по-настоящему сейчас не знает никто.

Родитель же теперь, в свои 80 — 85, тоже совсем иной пошел. Очень даже в этом возрасте
активный и самостоятельный и часто совсем не очень управляемый. Мы расскажем о том, как
строить отношения с пожилыми родителями так, чтобы отношения эти были (по
возможности) мирными, беcконфликтными и обоюдо-приятными.»

Миф о возрасте заменил реальность

Человека после 65 ждет незавидное будущее: серьезные проблемы со здоровьем,
нехватка средств к существованию, одиночество. Такое мнение высказало
большинство участников опроса, проведенного в 1975 и 1981 годах в США по
заказу National Council on Aging. Причем респонденты, которым было за 65, и сами
разделяли это мнение. Притом что большинство из них заявило, что сами они
пока не столкнулись с этими проблемами.

«Люди в возрасте покупаются на негативный образ старости, они очевидно

предполагают, что большинство людей в возрасте несчастны, а сами они просто
исключение из правила, — сделал вывод ученый Верн Бенгстон (Vern Bengston). —
Миф подменил собой реальность».

Страх неизвестного
Люди моложе 60 лет склонны переоценивать отрицательные
факторы, связанные с возрастом.

К таким выводам пришли ученые из исследовательского центра Pew. Данные

опроса американцев разных возрастных категорий показали, что молодые в
большей степени склонны ассоциировать пожилой возраст с болезнями,
снижением сексуальной активности, неспособностью самостоятельно водить
автомобиль и прочими расхожими клише.

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 Образ жизни важнее наследственности
Как сильно наше здоровье предопределено генетически? Чтобы ответить на
этот вопрос, в 1998 году шведские ученые решили изучить людей с общими
генами, но разным образом жизни. Они провели исследование близнецов,
которые оказались разлучены в детстве и воспитывались в разных условиях.
Если все зависит только от наследственности, то близнецы должны быть
примерно в одинаковой форме, несмотря на разницу в воспитании и
социальном положении. Однако на деле оказалось, что их состояние
здоровья сильно отличалось. Ученые пришли к выводу, что только от 20%
до 30% в нашем физическом состоянии определяется генами, а остальное
все-таки зависит от того образа жизни, который мы выбираем. В другом
исследовании близнецов, проведенном в лондонском King’s College спустя
десять лет, сравнивались братья и сестры, которые занимались
физическими упражнениями — с теми, кто пренебрегал нагрузками.
Оказалось, что первые старели медленнее вторых на клеточном уровне. В
некоторых случаях они оказывались на девять лет «моложе».

06/01/2012 | 10:25Поделитесь с друзьями:

Многие герои проекта «Возраст счастья» физически обладают фантастическими

возможностями, хотя считается, что если вам за шестьдесят, то все, что вам
остается, это тяжелый и болезненный процесс старения.

Главным результатом путешествия стало осознание того, что наше представление

о периоде после 60 или 65 лет не соответствует действительности. в этом возрасте
вполне можно жить полной, активной, здоровой и, что самое главное, счастливой
жизнью. Возраст «шестьдесят плюс» — не время упадка, как принято считать, и не
медленная деградация. Наоборот, этот возраст может быть вершиной
человеческой жизни, возрастом счастья, когда человек получает возможность
реализовать любую свою мечту.
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абсолютное большинство тех, кто живет долго и счастливо — в разных странах,
разных регионах мира, не сговариваясь и не имея коммуникаций друг с другом, —
тем не менее пользуются чрезвычайно схожими методами, способами,
позволяющими сохранить здоровье, активность и полноту жизни.

Возраст способствует инновациям

Исследования показывают, что в аспектах, связанных с
творчеством и инновациями, зрелый мозг работает лучше
молодого.
Правда, есть риск, что зрелый человек будет решать сегодняшние
задачи «вчерашними методами», полагаясь на личный позитивный
опыт. С другой стороны, с возрастом люди менее склонны выдавать
желаемое за действительное, предпочитая здраво оценивать,
актуальные ресурсы и нужды.
То есть, чем старше человек, тем больше вероятность, что он живёт
настоящим, чувствует потребности окружающих и может рождать
ценные реалистические идеи.

Чарльз Югстер
“Мы перепутали болезни и процесс старения, который вполне
может быть здоровым. Болезни вовсе не обязательное условие
старости!” - считает Чарльз Югстер. Вот уже больше 30 лет
продолжается его эксперимент, который он ставит на самом
себе.Чарльз хочет на своем опыте доказать, что можно стареть,
не болея.Свой эксперимент Чарльз Югстер начал в 60 лет.
Сейчас ему 93, он абсолютно здоров и вот уже много лет не
принимает никаких лекарств кроме витаминов и протеина,
который важен для роста мышц при силовых тренировках.
Эксперимент продолжается.

Это сейчас Чарльз Югстер неутомимый спортсмен. А до 60 лет он был

совершенным тюфяком, и всем спортивным упражнениям предпочитал

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возможность полежать на диване. От такого образа жизни у него развивался
варикоз, было пониженное давление, и прочие проблемы со здоровьем.

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В один прекрасный день Югстер узнал, что для людей его возраста проводятся
спортивные соревнования по гребле, вспомнил, что когда-то в юности занимался
этим спортом и решил снова попробовать.

Ради этого Чарльз встал с дивана и начал тренироваться. Два года спустя он понял,
что болезни больше его не беспокоят. Такая удивительная перемена заставила его
заинтересоваться процессами, которые происходят в человеческом организме
после 60 лет. И Чарльз начал экспериментировать. Он поменял систему питания,
продолжил тренировки и углубился в исследования.

В ходе исследований Югстер понял, что современное общество ошибается,

полагая, что процес старения и болезни неразделимы - это представление
совершенно не соответствует действительности. Причина многих болезней
возраста не столько в старении, сколько в том, что с годами жировая ткань
постепенно заменяет мышечную. - Ожирение это не просто накопление жира, -
говорит Югстер, - Именно лишний вес и отсутствие активности приводят к
диабету, сердечно-сосудистым заболеваниям и мноим другим болезням, не говоря
уже о последствиях для мозга.

Чтобы избежать этого, надо постоянно давать своему телу нагрузки. Примерно до
восьмидесяти лет Чарльзу относительно легко удавалось поддерживать себя в
хорошей форме. Он регулярно тренировался, следил за питанием и был доволен
своим самочувствием и атлетической фигурой.

- По моему опыту, если активно заниматься, то в семьдесят лет тело прекрасно

реагирует на нагрузки, практически также как в молодости! - говорит Чарльз.

Однако ближе к восьмидесяти пяти у Чарльза начался, как он теперь шутя это
называет, “кризис среднего возраста”. Добиваться результатов стало сложнее -
тело быстро набирало жир и теряло мышечную ткань, несмотря даже на
постоянные спортивные нагрузки.

“Я смотрел на себя в зеркало, и мне не нравилось то, что я видел, - рассказывает

Чарльз - Я решил, что надо обратиться за советом к людям, которые знают все о
быстром и эффективном наращивании мышц”.

Так 87-летний Чарльз Югстер стал бодибилдером.

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И за счет силовых тренировок и специальной диеты быстро вернул себе
утраченную форму и за год похудел на 12 килограммов!

Сейчас, в 93, Чарльз совершенно здоров, весит ровно столько же, сколько весил
когда его призвали в армию (это случилось в 1942 году) и за 45 секунд делает 50
отжиманий. Он по прежнему активно занимается и постоянно участвует в гребных
регатах, но теперь уже ведет занятия по специальной программе с
индивидуальным тренером, который специализируется на тренировках для людей
старше 70. И вместе с Чарльзом участвует в его эксперименте, набирая таким
образом уникальный опыт.

Несмотря на тренировки, регаты и спортивные чемпионаты, Чарльз Югстер и не

думает о выходе на пенсию. До 75 лет Чарльз работал зубным врачом, потом до 82
- издателем стоматологического информационного бюллетеня, а до 92 промо-
лицом в сети фитнес-центров. Сейчас, в 93, Чарльз подыскивает себе новую
работу.

- Между занятостью и здоровьем есть прямая связь, - уверен он. Чем дольше ты
работаешь, тем дольше остаешься здоровым.

Помимо новой работы Югстер ищет себе новую подругу. Чарльз овдовел много лет
назад, и холостяцкая жизнь ему надоела. Он с радостью познакомится с девушкой
лет 70-ти, но сразу предупреждает, что ищет подругу, а не жену - поскольку к браку
пока не готов.

Бетти Смит, Берил Ренвик

Бетти Смит 90 лет, Берил Ренвик - 86. Шесть лет назад -
практически чудом - они стали радиоведущими собственного
шоу. И хотя не имели никакого опыта в этой области, благодаря
своей непосредственности, оптимизму и чувству юмора быстро
стали популярными. Недавно их шоу получило золотую медаль
премии Sony Radio Awards.

Подруги Бетти и Берил впервые оказались в радиостудии ВВС в 2006 году, когда
Бетти было 84 года, а Берил - 80. Они пришли туда на экскурсию. Там-то на них и
обратил внимание продюсер Дэвид Ривс: он заметил, что две женщины без умолку
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болтают друг с другом, шутят и периодически покатываются со смеху. Ривс понял,
что Бетти и Берил просто созданы для радиоэфира. И, хотя никакого опыта
работы на радио у подруг и в помине не было, Дэвид предложил им вести шоу на
местной радиостанции и с радостью сам стал его соведущим.

С тех пор каждую субботу жители графства Хамберсайд слушают, как Дэвид, Бетти
и Берил обсуждают события недели (а заодно и события предыдущих лет 80) и
высказывают мнения обо всем на свете. При этом подружки постоянно
подтрунивают над Дэвидом, Дэвид - над Бетти и Берил, и все трое очень
заразительно хихикают. Не удивительно, что их аудитория составляет около 20
тысяч слушателей.

Бетти и Берил нарушают все мыслимые правила радиошоу. Они разговаривают

во время музыкальных отбивок, отпускают едкие комментарии в адрес
музыкантов и композиций, которые ставят в эфир (“у этой Мадонны обе ноги -
левые”) и шуршат конфетными обертками при включенных микрофонах. Тем не
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менее, в мае 2012 года их шоу выиграло золотую медаль на конкурсе Sony Radio
Awards, и ведущие стали знаменитостями национального масштаба.

Сейчас Бетти и Берил продолжают выходить в эфир каждую субботу. “Когда я

захожу в студию, то чувствую себя как дома”, - признается Берил.

Итальянец окончил школу в 91 год и

планирует поступить в вуз

25 июня 2015, 17:16

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Житель Италии, окончивший среднюю школу на 92-м году жизни, не собирается
останавливаться на достигнутом и планирует поступить в ВУЗ. Всю жизнь пожилой
выпускник средней школы посвятил работе и семье, поэтому заняться повышением уровня
своего образования он смог только в преклонном возрасте.

Никола Торелло, который успел за свою жизнь стать отцом четверых детей и дедом шести
внуков, к учебе отнесся со всей серьезностью и не пропускал ежедневных занятий в
вечерней школе. После окончания школьного курса он успешно сдал шесть выпускных
экзаменов.

Высшие оценки он получил за работу по математике и за эссе об итальянском поэте

Алессандро Манцони. Высший бал получил пожилой выпускник и за устный экзамен по
английскому языку, для которого он подготовил рассказ о своей покойной жене Лисии.

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Получение аттестата Никола Торелло отпраздновал в кругу семьи, а также вместе со
своими преподавателями и мэром Кьети Умберто ди Примо.

Однако успешного окончания средней школы пенсионеру оказалось мало. Итальянец не

собирается останавливаться на достигнутом и планирует продолжить учебу.

Как рассказал пожилой выпускник в интервью для издания The Local, он планирует
поступать в ВУЗ. Торелло признался журналистам, что мечтает изучать гуманитарные
предметы, однако не имеет для этого возможности. Чтобы учиться в выбранном им
учебном заведении ему придется ежедневно ездить в центр города, что для него
проблематично, поэтому пенсионер решил пойти в находящийся рядом с его домом
политехнический институт.

Также пожилой выпускник признался, что у него есть еще она мечта, которую он намерен
воплотить в жизнь - научиться пользоваться компьютером.

Авторы статьи отмечают, что 91-летний выпускник школы в свободное от учебы время
занимается спортом - дважды в неделю он посещает бассейн.

«В моем возрасте важно быть чем-то занятым», - цитирует издание слова итальянца.

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 sicocxlis dasasruli: fiqrebi sikvdilis Sesaxeb da sikvdilis miReba.

sikvdili aris bolo kritikuli movlena adamianis cxovrebaSi.

fiziologiur doneze sikvdili warmoadgens yvela sasicocxlo funqciis
Seuqcevadad Sewyvetas. xolo fsiqologiur doneze mas mniSvneloba aqvs
piradad momakvdavisa da misi axloblebisTvis. mokvde, niSnavs rom veRar
grZnob, toveb axloblebs, daumTavrebel saqmeebs da gadadixar
usasrulobaSi. magram sikvdili kulturis mniSvnelovani komponenticaa.
is aisaxeba literaturaSi, xelovnebaSi, musikaSi, religiasa da
kulturis filosofiaSi da gansaxierdeba ritualebsa da wes-CveulebebSi.
dabadeba da sikvdili bunebrivi movlenebia, magram maTi emociuri
gavlena da pirovnuli Rirebuleba mniSvnelovnad gansxvavdeba. adamianis
dabadebas elian sasiamovno mRelvarebiT da optimizmiT; sikvdilze fiqrs
ki adamianebi gaurbian da uaryofen kidec.

sikvdilis uaryofa
rodesac adamiani kvdeba, axloblebs aramarto ar surT masTan
amaze saubari, aramed TviTon momakvdavsac ukrZalaven amas. adre adamiani,
Cveulebriv, kvdeboda saxlSi, ojaxis wevrebis zrunviT garemoculi. aqve
sruldeboda tradiciuli ritualebi da wes-Cveulebebi. XX saukunis
Semdeg mdgomareoba ramdenadme Seicvala. adamianTa sul ufro meti
raodenoba kvdeba saavadmyofoSi da maTze samedicino personali zrunavs.
uaryofam SeiZleba xeli SeuSalos stresis aqtiur daZlevas.
sikvdilisTvis aqtiurad winaaRmdegobis gawevas.

sikvdilis mniSvneloba.
xandazmul asakSi, samwuxarod, iSviaTi araa naTesavis, megobris an
meuRlis sikvdili. mwuxarebis gancda gansakuTrebiT mwvavea meuRlis
dakargvis dros. reaqcia sayvareli adamianis sikvdilze ganxvavdeba
pirovnebis, asakis, sqesis, kulturuli tradiciebisa da
gardacvlilisadmi damokidebulebis mixedviT. moaruli Sexeduleba, rom
mwuxarebisa da emociebis aqtiurad gamoxatva xels uwyobs am
mdgomareobidan gamosvlas, simarTles ar unda Seesabamebodes. zogi
mecnieris azriT, axlobeli adamianis sikvdilze pirveli reaqcia aris
Soki _ faza, romelic xSirad ramdenime dRe grZeldeba, zogjer ki
gacilebiT metic. adamianis moulodneli sikvdilis SemTxvevaSi
axloblebi SesaZloa srulad ver acnobierebdnen danakargs da
gaognebuli iyvnen momxdariT. meore fazaze SesaZloa mwuxareba ufro

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aqtiurad gamoixatos (tirili, moTqma). Cndeba tanjvisa da monatrebis
gancda. zogjer SeiniSneba sisuste, uZiloba, umadoba, interesis dakargva,
SeiZleba gamovlindes depresiis niSnebic. droTa ganmavlobaSi TandaTan
xdeba axal garemoebebTan Segueba. marto mcxovreb qvrivebs xSirad
uCndebaT praqtikuli da fsiqologiuri siZneleebi (yofiTi problemebis
mogvareba, socialuri kontaqtebis SenarCuneba dasxv.). maT mxardaWeras
cdiloben naTesavebi, megobrebi, magram yvelaze didi wili mainc
Svilebze modis. yvelaze martosulad Tavs uSvilo qvrivi qalebi
grZnoben.
moxucebis da ukurnebeli seniT Sepyrobili adamianebis damokidebuleba
sikvdilisadmi ramdenime stadias gaivlis:

• uaryofis stadiaze adamians ar unda aRiaros, rom SeiZleba mokvdes da eZebs

sxva, imedis momcem argumentebs da diagnozebs.

• roca acnobierebs, rom marTla kvdeba, mas eufleba brazi, wyena da Suri sxva
adamianebis mimarT ("ratom me?") _ es aris risxvis stadia.

• vaWrobis stadiaze adamiani eZebs saSualebebs, rom gaixangrZlivos

sicocxle, Seimsubuqos tkivili da tanjva. mzadaa dados piroba da
SeTanxmeba RmerTTan, eqimTan, sxva adamianTan.

• Semdeg adamians SeiZleba daeuflos uimedobis gancda. dgeba depresiis

stadia. momakvdavi wuxs, rom uxdeba ganSoreba axloblebTan.

• miRebis stadiaze adamiani emorCileba beds da mSvidad elis aRsasruls.

moaxloebulma sikvdilma SeiZleba aiZulos adamiani gadaxedos Tavis

cxovrebas, gansazRvros ra aris misTvis mniSvnelovani, ras warmoadgens is
sinamdvileSi. roca adamians SeuZlia Tavis Tavs uTxras: "me kmayofili var" _
sikvdilis mas aRar eSinia. aseTi adamianebi Tavisi cxovrebis gagrZelebas
STamomavlebSi da sakuTar namoRvawarSi xedaven. eriksoni maT ego-
integrirebulTa kategorias miakuTvnebda. Tumca aris adamianTa meore
kategoria, romlebisTvisac cxovreba mxolod ararealizebuli
SesaZleblobebisa da Secdomebis Tanmimdevrobaa. cxovrebis bolos isini
acnobiereben, rom gviania yvelafris Tavidan dawyeba. ego-integraciis ar
arseboba (an nakleboba) maTSi aCens sikvdilis SiSs, gamudmebuli uiRblobisa
da sinanulis gancdas. isini wuxan imaze "rac SeiZleba moxdes?!" da axdenen
sakuTari naklis proecirebas gare samyaroze.

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 Я хочу научиться стареть
Хорошо стареть можно научиться, уверена психотерапевт Мария де
Энзель. Это искусство, и им стоит овладеть, чтобы идти по этой части
нашего пути с большим доверием к жизни. Перешагнув шестой десяток
в тревоге за уходящие годы, наш корреспондент решила побывать на
одном из тренингов.
Элен Матье

В анкете участника тренинга, которую я держу в руках, читаю фразу: «На этом
пятидневном семинаре нам предстоит научиться проживать свое старение с радостью».
Хотя мне трудно себе представить, как на такое может хватить пяти дней, но болезненное
чувство, которое вызывает приближение собственной старости, и восхищение, с которым я
отношусь к книгам и работе Марии де Энзель, побуждают меня записаться. Дети
стараются меня подбодрить саркастическими ремарками: «И что ты там будешь делать –
среди старичья? Ты-то не старая!» Но меня не утешают ни их любящие глаза, ни то, что
они отказываются видеть, как мать их действительно меняется. Мой взгляд более трезв. Я
знаю каждую свою морщинку, каждую слабость своего тела; у меня временами болит
колено, я забываю названия фильмов и то, куда только что положила очки... Мне 60 лет, и
мне хочется повернуть время вспять.

Первый день Я играю с образами Старости

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Спустя несколько недель я стою в уютном холле отеля и неприязненно присматриваюсь к
полутора десяткам участников семинара, собравшихся на приветственный коктейль:
«Неужели на вид я такая же старая?» Потом к нам присоединяется ведущая – Мария де
Энзель. Спрашивать, сколько лет ей самой, даже в голову не приходит – она прекрасна,
она словно излучает свет. Ощущение радостной безмятежности, согласия со своим
возрастом. Сначала каждому из нас по очереди предстоит рассказать, что нас сюда
привело. Ответы звучат робко: упоминают о страхе одиночества, болезней, о мучительном
переживании вдовства, о старости собственных родителей, чей опыт не хочется повторить.
Я признаюсь, что боюсь стать в тягость близким, боюсь стать одной из тех сварливых и
вечно недовольных старух, которых все избегают. Мария слушает молча, потом берет
слово. «Именно нашему поколению досталась задача создать новое искусство стареть.
Задача непростая, потому что наше общество рисует нам безотрадную картину старости.
Но есть способы ее исправить. Будем же первопроходцами». Потом она рассказывает о
столетних долгожителях японского острова Окинава, которые каждое утро произносят как
молитву: «Жар сердца не дает нашим телам стареть». И живут счастливо, потому что все
относятся к ним как к сокровищу. «Давайте постараемся быть для других сокровищем, а
не тем, кто отравляет жизнь. Старость можно воспринимать и как продолжение нашего
роста, и как конец всего. Превратить ее в крушение легко, но давайте учиться расти вместе
с возрастом».

Первое упражнение: найти среди своих знакомых человека глубоко в летах, на которого
нам хотелось бы походить, и перечислить его достоинства. Так постепенно возникает
идеальный образ радостного, воодушевленного старика, который может передать свои
знания молодым, открытого людям, по-прежнему верного своим устремлениям и со
спокойной ясностью принимающего мысль о смерти. Мы все с удовольствием
погрузились в эти изыскания. Дальше продолжаем в том же духе – ищем в разных
журналах подходящие картинки и фразы, чтобы сделать из них коллаж. Лист бумаги
разделен надвое: на одной половине нам предстоит разместить негативные образы
старости, на другой – позитивные. «Пусть вами руководит ваш внутренний ребенок;
поиграйте со словами и картинками», – советует Мария. Все вырезают и клеят, как когда-
то на школьном уроке. Мой лист заполняется мрачными образами. Поперек ложатся
набранные жирным шрифтом слова: «болезнь», «печаль», «молчание», «смерть»… Лицо,
закрытое темной вуалью (найдено в рекламе туфель марки люкс), заполняет собой
пространство, а сверху я рисую небо в черных тучах. На той половине, где надо наклеить
светлые картинки, едва хватает места для дерева с раскидистыми ветвями и раскрытой
женской ладони. Защита и забота о других. Я замечаю, что негативные картинки я клеила с
чувством дискомфорта, зато каждый позитивный образ словно рождал внутри меня

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улыбку. Может быть, это начало примирения? Мы объясняем Марии детали своих
коллажей, а она записывает наши страхи на доске и завершает этот первый день фразой,
которая отзывается в каждом из нас: «Хорошо стареть – это значит принимать потери».

Психолог и психотерапевт Мария де Энзель (Marie de Hennezel) долгое время занималась практикой
психологической поддержки людей в конце жизненного пути. Она – автор многих книг, в том числе
«Смерть вблизи», «Забота о другом» («La Mort intime», «Le Souci de l'autre», Robert Laffont, 2001, 2004),
«Жар сердца не дает нашим телам ржаветь» («La chaleur du coeur empêche nos corps de rouiller», Pocket,
2010).

Emotional Fitness in Aging: Older is Happier

Older adults accentuate the positive.

What the Research Shows

Belying the stereotype of cranky old people, older adults actually appear to enjoy pleasant emotions and recall more
positive images than do younger adults. Ongoing psychological research is painting a new and reassuring picture
about how older adults feel. The findings attest to a healthy degree of emotional fitness.

In 2001, Susan Turk Charles, PhD, Chandra Reynolds, PhD, and Margaret Gatz, PhD, reported that the tendency
exhibited by most people to have a positive outlook extends into old age. A longitudinal study of 2,704 people in four
generations of families, which ran from 1971 to 1994, asked participants "positive affect" (emotion or mood) questions,
such as, "During the past few weeks, did you ever feel particularly excited or interested in something?" They also
asked "negative affect" questions, such as, "During the past few weeks, did you feel so restless that you couldn't sit
long in a chair?"

The researchers found that for all generations, negative affect decreased with age. In other words, as people got
older, they got less negative. Positive affect stayed fairly stable across time, with a small decrease for the oldest
people in the study. However, older participants who were more outgoing were less likely to show a drop in positive
affect.

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In 2003, Dr. Charles, with Mara Mather, PhD, and Laura Carstensen, PhD, reported on additional research showing
that older adults recall relatively more positive and fewer negative images than younger adults. Two studies examined
age differences in memory for positive, negative and neutral images of people, animals, nature scenes and inanimate
objects. For example, among the "people" pictures, a positive image showed a man and a young boy at the beach
watching seagulls overhead; a negative image showed a couple looking sorrowful as they stand in a cemetery and
stare down at a tombstone; and a neutral image showed scuba divers checking their gear by the side of a dock.

In both experiments, the psychologists showed participants the images and then tested recall (how many they
remembered) and recognition memory (whether they accurately picked what they saw from a larger group of images).
Older adults (ages 65-80) recalled fewer negative images relative to positive and neutral images. In that older group,
recognition memory also decreased for negative pictures. As a result, the younger adults (ages 18-29 and 41-53)
remembered the negative pictures better. What's more, although both younger and older adults spent more time
viewing negative images, only the younger group recalled and recognized them better.

What the Research Means

These psychological studies document the tendency of older people to regulate their emotions more effectively than
younger people, by maintaining positive feelings and lowering negative feelings. Thus, aging does not automatically
bring a bad outlook.

The research supports the "socioemotional selectivity" theory that, as people get older and become more aware of
more limited time left in life, they direct their attention to more positive thoughts, activities and memories. In their
report, the authors wrote that, "With age, people place increasingly more value on emotionally meaningful goals and
thus invest more cognitive and behavioral resources in obtaining them."

Physiology may aid the process. Dr. Mather and additional colleagues have done preliminary brain research
suggesting that in older adults, the "amygdala," an almond-shaped part of the temporal lobe that's associated with
emotion, is activated equally to positive and negative images, whereas in younger adults, it is activated more to
negative images. This suggests that older adults encode less information about negative images, which in turn would
diminish recall.

Meanwhile, psychologist Quinn Kennedy, PhD, with Drs. Mather and Carstensen, conducted a longitudinal study in
which they asked older and younger adults to recall their physical, mental, and emotional well-being from a prior point
in time. Older people recalled their past health - 14 years prior -- as being more positive than did younger people,
even though the amount of time that had passed was held constant. When older and younger adults were asked to
recall their past, the older but not younger adults reported that their mood improved. Importantly, the findings were not
attributed to age-related declines in memory.

W. Richard Walker, PhD, and colleagues cite additional findings from cross-sectional studies that pleasant emotions
fade more slowly from memory than unpleasant emotions - perhaps because we try harder to minimize the negative
impact of life events. Dr. Walker view this kind of emotional fade-out as a healthy way of coping. Given older peoples'
storehouse of memories, it may be especially helpful. But the longitudinal studies by Dr. Charles and her colleagues

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were able to illuminate the actual changes as people grow older. Longitudinal studies are essential for psychologists
to understand the true dynamics of aging.

How We Use the Research

Clearly, older people (generally age 65 and up) are not the crotchety sourpusses that popular images and mass
media often make them out to be. Rather, they are continuing a lifelong human tendency to look on the bright side
and minimize the impact of negative events. Knowing that older people are generally positive may help younger
people look forward to that time in life, rather than dread it. Older people can feel good about being able to keep
themselves emotionally healthy, which in turn aids immunity and other aspects of physical health, as shown in a study
by Lynanne McGuire, PhD, Janice Kiecolt-Glaser, PhD, and Ronald Glaser, PhD. In addition, doctors can be aware
that because older people tend to be more positive, expressions of negativity are less likely to be a sign of normal
aging and more likely to be, perhaps, a sign of depression.

Cited Research

Charles, S. T., Reynolds, C. A. & Gatz, M. (2001). Age-Related Differences and Change in Positive and Negative
Affect Over 23 Years. Journal of Personality and Social Psychology, 80(1).

Kennedy, Q., Mather, M., & Carstensen, L. L. (2004). The Role of Motivation in the Age-Related Positivity Effect in
Autobiographical Memory. Psychological Science, 15(3).

McGuire, L., Kiecolt-Glaser, J. K., & Glaser, R. (2002). Depressive Symptoms and Lymphocyte Proliferation in Older
Adults. Journal of Abnormal Psychology, 111(1).

Charles, S. T., Mather, M., & Carstensen, L. L. (2003). Aging and Emotional Memory: The Forgettable Nature of
Negative Images for Older Adults. Journal of Experimental Psychology: General, 132(2).

Walker, W. R., Skowronski, J. J., & Thompson, C. P. (2003). Life is Pleasant - and Memory Helps to Keep It That
Way!" Review of General Psychology, 7(2).

Tasks and Decisions

As people approach the end of their lives, they and their families commonly face tasks and decisions that include a
broad array of choices ranging from simple to extremely complex. They may be practical, psychosocial, spiritual, legal,
existential, or medical in nature. For example, dying persons and their families are faced with choices about what kind
of caregiver help they want or need and whether to receive care at home or in an institutional treatment setting. Dying

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persons may have to make choices about the desired degree of family involvement in caregiving and decision-
making. They frequently make legal decisions about wills, advanced directives, and durable powers of attorney. They
may make choices about how to expend their limited time and energy. Some may want to reflect on the meaning of
life, and some may decide to do a final life review or to deal with psychologically unfinished business. Some may want
to participate in planning rituals before or after death. In some religious traditions, confession of sins, preparation to
"meet one's maker," or asking forgiveness from those who may have been wronged can be part of end-of-life
concerns. In other cultural traditions, planning or even discussing death is considered inappropriate, uncaring, and
even dangerous, as it is viewed as inviting death (Carrese & Rhodes, 1995).

All end-of-life choices and medical decisions have complex psychosocial components, ramifications, and
consequences that have a significant impact on suffering and the quality of living and dying. However, the medical
end-of-life decisions are often the most challenging for terminally ill people and those who care about them. Each of
these decisions should ideally be considered in terms of the relief of suffering and the values and beliefs of the dying
individual and his or her family. In addition, any system of medical care has its own primary values that may or may
not coincide with the values of the person. For example, in most Western medical systems the principles of individual
autonomy (though not to the exclusion of family members and intimates) and informed consent are primary. In
contrast, many cultures eschew the principle of autonomy and the principle of interactive, community decision-making
is thought to be the ideal. Therefore, well-intentioned presentations of treatment or care possibilities by health care
providers may overlook a particular person's wish not to discuss death.

Reference

Carrese, J. A., & Rhodes, L. A. (1995). Western bioethics on the Navajo reservation. JAMA, 274, 826-829.

Issues to Consider

Many factors can impact the decisions people make at the end of life. Below is a categorized list of issues that have
been identified in the literature as potentially influencing what particular decisions are made and the process by which
such options are selected. The following should be considered a general outline of what a psychologist may want to
explore when faced with a person who is trying to make an end-of-life decision, such as voluntarily stopping eating or
drinking, withholding or withdrawing treatment, or receiving assisted suicide. No definitive guidelines for assessment
in the terminal stages of life have been established and endorsed by a nationally recognized organization. Further, the
material below is based on theory, anecdote, and clinical experience - it is not empirically based and needs to be
researched and validated. There are some who would therefore argue that mental health professionals should not
engage in anything that appears like an "evaluation" because the issues listed below and the manner in which they
are explored are socially constructed. Therefore, the list below should not be interpreted as being prescriptive or as a
standard of care. Nor should it be used to evaluate the adequacy of an "assessment" undertaken by a clinician.

The outline is based on a variety of sources in the literature (Block & Billings, 1998; Emanuel, 1998; Farberman, 1997;
Farrenkopf & Bryan, 1999; Goldblum & Martin, 1999; Jamison, 1997; Miller, Hedlund, & Murphy, 1998; Muskin, 1998;
National Association of Social Workers, 1994; Sanson et al., 1998; Veterans Affairs National Center for Cost
Containment, 1997; Werth, 1999a; Werth, Benjamin, & Farrenkopf, in press; Werth & Gordon, 1998). Note that the
process described is quite comprehensive and not every component will be relevant to each situation. It is also
important to note that some authors (e.g., Sullivan, Ganzini, and Youngner, 1998) have been critical of a mental
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health professional merely assessing capacity for assisted suicide, and therefore acting as a "gatekeeper". Therefore,
clinicians may want to view their role as helping to determine if the person has impaired judgment, not merely whether
she or he has capacity to make health care decisions.

It should be emphasized that the following process is designed to be used with a wide variety of end-of-life decisions,
not just those involving a decision that may affect the timing of death. For example, dying individuals will need to
make decisions about what they want to say to other people; whom they want at their side during the dying process;
what they want in their wills; whether they want someone to have durable power of attorney for health care for them
and, if so, who; how they want to structure their final days; and so forth. Note that the list of ideas for how to proceed
is focused on reviewing the terminally ill individual's decisional process since this document is not addressing the
extremely complex topic of surrogate decision making.

Preliminary Considerations

The following five steps are not a part of the actual outline but are intended to be general issues for professionals to
consider.

1. Psychologists need to assess their own personal and professional beliefs about the dying process and
different end-of-life decisions and consult with others regarding the degree to which their attitudes, values,
and beliefs could affect or bias the review process.
2. If, following this personal/professional assessment and consultation, psychologists believe they can
participate, they must obtain appropriate training in relevant end-of-life-related issues.
3. If professionals plan on being involved in this area, they need to find at least one experienced colleague with
whom they can consult during reviews to determine if the discussion and interpretations are appropriately
comprehensive, if the psychologist's own values are affecting the process, or when referral to another
professional may be necessary.
4. The dying person's health care team must be integrated into the review process, through asking them
questions, providing them with information, and making appropriate referrals.
5. Throughout the review process professionals need to keep detailed case notes describing why they covered
what they did and why other areas were not explored in more depth.

Outline of Issues for Consideration

The issues to be considered are divided into four broad areas. Depending on the prognosis for the dying person, his
or her physical ability to participate in an extended interview or multiple meetings, and the referral question(s), one or
more of the last three sections may need to be reduced in emphasis or eliminated. Striking an appropriate balance
between the person's physical condition (so that he or she is not over burdened by the review) and the psychologist's
needs (in order for a comprehensive review can be conducted) will be difficult, and therefore may increase the
possibility that the professional's values may enter into the situation (Fenn & Ganzini, 1999; Ganzini, Fenn, Lee,
Heintz, & Bloom, 1996). However, if time and the client's condition permit, all of the following topics may be relevant
and therefore should be considered areas to be explored, and the professional should utilize the consultant to
determine if value judgments are interfering with making unbiased interpretations.

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 1. A necessary first step is to determine if the individual has capacity to give informed consent to participate in
the review and, further, the capacity to make informed health care decisions.
1. Conduct a Mental Status Evaluation, using standardized procedures and scoring, being especially
vigilant for signs of dementia and/or delirium;
2. Determine if the individual can perform all of the following tasks as they pertain to the review:
1. Understand and remember relevant information, including the fact that the professional will
need to confer with members of the individual's health care team as well as the person's
significant others,
2. Appreciate the consequences (i.e., costs and benefits) of different possible decisions,
3. Demonstrate a clearly held and consistent underlying set of values that provide some
guidance for making the decision,
4. Communicate the decision and explain the process used for making it;
Determine if the person can perform the following tasks as they pertain to his or her health care:
0. Understand and remember relevant information about his or her diagnosis, prognosis, and
treatment alternatives (especially hospice and palliative care and advance directives),
1. The last three items in (b) above;
If the person has the aforementioned capacities, then the professional should have the dying person sign a
release of information form and the psychologist should then obtain medical records so that members of the health
care team can be consulted. The records need to be available for the next steps in the outline, while the interviews
with health care team members can take place either before or soon after the first interview with the dying individual.
These consultations should review the team members'(1) perceptions of the individual's condition, prognosis, and
treatment options, and (2) beliefs about what they told the person about his or her condition, prognosis, and treatment
options. These meetings should take place before the process is considered complete because they will often lead to
a need to clarify discrepancies between what the health care team reports and what the dying person states.
If a person has capacity to make decisions about involvement in the review and about his or her health care,
the next step is to discuss the decision-making process the person has used, focusing on the issues that the
individual stated (in 1c, above) were important parts of his or her thinking on the matter. Important areas to explore
may include:
Physical pain and suffering: Although most physicians have training in pain management and alleviating
distressing symptoms, it is widely recognized that pain is undertreated and some symptoms are poorly controlled;
therefore, even though the psychologist may not be an expert in physical symptomology, the degree to which physical
pain as well as other aspects of suffering are involved in the person's decision making must be reviewed.
Comorbid psychological conditions: Disruptions of thought and affect caused by the following conditions may
not be severe enough to make a person incapable of making decisions, but they can significantly affect decision
making as well as impair quality of life (note: the psychologist may utilize appropriate standardized assessment tools
as long as the instruments can be justified because of a need to document a condition the professional has detected
and are not used merely to rule out hypothetical problems):
0. Clinical depression and other mood disorders,
1. Clinical anxiety disorders (including acute stress disorder and posttraumatic stress
disorder),
2. Early-stage dementia,
3. Fluctuating states of delirium and/or psychosis,

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 4. Personality disorders (note: the presence of a diagnosable personality disorder would not
disqualify a person's end-of-life decisions; however, awareness of such a diagnosis would
help the professional put other aspects of the discussion into the appropriate context),
5. Substance abuse (including accidental or purposeful abuse of/dependence on prescribed
medication);
Other psychological issues: In addition to formally diagnosable conditions, there are a host of other issues
associated with the individual himself or herself that need to be reviewed:

0. Ambivalence or rigid thinking,

1. Fears (e.g., of pain, loss of mental status),
2. History of actual and perceived trauma and loss (including traumatic head injury),
3. Hopelessness and despair,
4. Internalization of societal rejection (e.g., self-hatred due to sexual orientation - "internalized
homophobia"; internalized low sense of entitlement in women),
5. Religious, spiritual, and existential beliefs, expectations, experiences, and values; sense of
personal meaning and fulfillment in life; philosophy of life and life values; assumptive world
components;
Fear of loss of control/loss of autonomy/loss of dignity: Research has indicated that these issues are the
primary reasons given by people who want to take an action that may impact the timing of death and therefore they
deserve careful exploration;
Financial concerns: Issues associated with the cost of medical care may play a role in end-of-life choices so
a discussion of the degree to which monetary matters are a part of the decision is important. (Note: there is some
debate in the literature about whether the presence of financial concerns should disqualify a person's decisions. For
some this is perceived to be a form of societal coercion while for others it is a natural consideration that may be seen
as altruistic. It will be up to the professional, perhaps after peer consultation, to determine whether any financial
concerns that are present are impairing the dying person's judgment);
Cultural factors: As reviewed earlier, people of diverse backgrounds hold differing attitudes toward various
end-of-life decisions so exploring ways in which culture may be affecting decision making must be included in the
review:

0. Cultural expectations and traditions associated with decision making, end-of-life issues,
and values,
1. Impact of personal characteristics, such as age, ethnicity, gender, economic status, and
disability;
Review possible underlying issues: Resolution of the following issues, if present, should not be expected, nor
required. These areas are listed because of their potential for decreasing quality of life and impacting relationships:

0. Is the request for assistance in dying a form of communication and what is being
communicated?
1. Is there a "split in the experience of the self" such that the person wants the sick part of the
self to die but the healthy part to live? If so, what impact is this having on the decision
making?

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 2. How is the person's ego functioning and related issues (e.g., coping and defense
mechanisms, frustration tolerance, character scripts, locus of control and processing,
cognitive style and biases, problem-solving skills, and ways of managing psychosocial
transitions) affecting the decision?
3. How are the person's specific strengths, skills, and assets, vulnerabilities, and liabilities
influencing the decision-making process?
4. Are rage, revenge, and helplessness involved in the process and what do they represent to
the person?
5. Are guilt, shame, self-punishment, and atonement affecting the quality of life and the end-
of-life decision?
6. Is the person viewing life as having already come to an end and how is this impacting the
decision-making process and review?
Overall quality of life: Generally speaking, how good does the individual believe his or her quality of life is at
the present time, what does he or she envision for the near future, and what could change the present and
prospective quality of life for the better?
Other issues to explore: If these issues have not already been discussed, the following topics deserve
consideration:

0. Has the person been suicidal in the past?

1. How long has the person been thinking about his or her end-of-life options?
2. How long ago was a decision made?
3. Why was the decision made when it was and, if there is a significant time gap between
when the decision was made and when the review is being conducted, why is the
discussion being held now?
4. If the person was going to follow through with the end-of-life decision, when would action
take place and why then?
The next major area for review is the person's social support system. Releases should be signed so that the
professional can talk with the important people in the dying individual's intimate circle.

Consideration of significant others: How has the presence or absence of significant others impacted the
person's decision making:

0. Review the beliefs the person has about the potential impact on the significant others
(including those yet-to-be-born), if any, of a particular decision,
1. If the individual insists there are no significant others, including friends, discuss the degree
to which this isolation (and, possibly, loneliness) may be amenable to change and the
effect such a change might have on a decision,
2. Examine the degree to which concerns about being a burden on others (physically,
emotionally, financially, etc.) are influencing the decision;
Involvement of significant others: Discuss the presence of significant others in the client's life and consider
suggesting that, if possible, they become involved in the decision-making process in some way:

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 0. If the individual is unwilling to have significant others involved, review the reasons for this
decision and discuss the impact their lack of involvement may be having on his or her
decision making,
1. If the person is willing to have significant others involved but has not included them to this
point, discuss how such involvement will occur and how this plan impacts the review,
2. If the dying person is uncertain about involving significant others, discuss the issues until
some decision can be made and then follow the first two bullets in this item, depending on
which is most appropriate given the decision made,
3. If significant others have been involved, find out what the dying person believes took place
in the discussions and whether there is any unfinished business,
4. Review if there has been any direct or indirect, subtle or overt, actual or perceived,
pressure from significant others on the decision-making process;
Interviews with significant others: Consider reviewing at least the following issues related to the terminally ill
person with members of his or her support system; if any areas of concern arose during the interview with the ill
individual, ask about them in this section as well:

0. Current functioning,
1. Recent changes in physical, mental, or emotional health,
2. Medical and psychosocial history, especially psychological problems and substance
abuse/mis-use,
3. Typical pattern of adjusting to loss, change, and illness,
4. Personality style,
5. Reasons for considering particular options and the significant other's reactions to these
reasons,
6. Areas of unfinished business,
7. Extent of financial concerns of all involved,
8. Other issues of concern related to the interviews with the dying person (e.g., if the dying
individual's response to questions about his or her fears of dying and death need
clarification or raised concerns in the professional, questions about this area can be asked
of the significant others).
The final broad area that should be reviewed includes systemic and environmental issues. The goal here is
to explore for the presence of any pressures from outside sources that may be impinging on the person's decision
making.

Indirect external coercion: To what extent are pervasive societal conditions and attitudes negatively
impacting the individual's life and, perhaps, causing him or her to feel as if there are no satisfactory options that will
provide for a decent quality of life, such as:

0. Negative biases toward older persons, persons with disabilities, women, members of
minority ethnic groups,
1. Lack of funding for basic health care needs, inadequate resources for persons with chronic
and disabling conditions, poorly trained professional caregivers, and other problems;

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 Direct external coercion: Pressure to make a particular decision may be subtle or overt, may be actually
occurring or merely a perception of the individual, could occur intentionally or accidentally, for example:

0. Are health care providers, administrators, and/or insurers/payers pressuring the client to
make a decision that will cut expenses, open up space, or for some other reason?
1. Has a medical provider suggested scaling back treatment or offered some specific options,
leading the person to believe he or she has been given up on or abandoned by
professional caregivers.

Role of the Psychologist after the Review is Complete

After conducting a review the professional must prepare detailed case notes. These notes should thoroughly
document whether the psychologist believes the dying person has capacity to make health care decisions and, if so,
whether there are any factors that are impairing the individual's judgment regarding the end-of-life decision. If no
impairment is detected, the notes should describe the review process and highlight how potential areas of concern
were covered and eliminated. If impairment is found, the notes should detail how the professional came to this
conclusion and offer treatment recommendations, with the strong stipulation that the person needs to meet with a
professional to determine capacity before any end-of-life decisions are implemented. Finally, appropriate referrals
(e.g., to attorneys, spiritual advisors, etc.) should be included in the recommendations section, regardless of whether
capacity is present.

Use of Instruments when Reviewing End-of-Life Decisions

At times it may be helpful for a psychologist to use objective or subjective measures to gather more information. The
use of such instruments must be carefully considered and the potential utility must be balanced with the person's
physical state and abilities, tolerance for completion of questionnaires, and the concerns of the professional. The only
instrument that may be warranted for use with most individuals is the MacArthur Competence Assessment Tool -
Treatment (Grisso & Appelbaum, 1998) because its semi-structured format provides a framework within which
assessments of capacity can be conducted.

The decision of which additional measures would be warranted will have to be made by the psychologist on a case-
by-case basis, given the unique characteristics of the situation and the constellation of issues presented by the dying
person. A comprehensive list of measures that may be appropriate for use with individuals at the end of life may be
found in the Center to Improve Care of the Dying's "Toolkit of Instruments to Measure End of Life Care". For
suggestions of other instruments see Farrenkopf and Bryan (1999); Werth (1999b); and Werth, Benjamin, and
Farrenkopf (in press).

References

Block, S. D., & Billings, J. A. (1998). Evaluating patient requests for euthanasia and assisted suicide in terminal
illness: The role of the psychiatrist. In M. D. Steinberg, S. J. Youngner (Eds.), End of life decisions: A psychosocial
perspective (pp. 205-233). Washington, DC: American Psychiatric Press.

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Emanuel, L. L. (1998). Facing requests for physician-assisted suicide: Toward a practical and principled clinical skill
set. JAMA, 280, 643-647.

Farberman, R. K. (1997). Terminal illness and hastened death requests: The important role of the mental health
professional. Professional Psychology: Research and Practice, 28, 544-547.

Farrenkopf, T. & Bryan, J. (1999). Psychological consultation under Oregon's 1994 Death With Dignity Act: Ethics and
procedures. Professional Psychology: Research and Practice, 30, 245-249.

Fenn, D. S., & Ganzini, L. (1999). Attitudes of Oregon psychologists toward physician-assisted suicide and the
Oregon Death With Dignity Act. Professional Psychology: Research and Practice, 30, 235-244.

Ganzini, L., Fenn, D. S., Lee, M. A., Heintz, R. T., & Bloom, J. D. (1996). Attitudes of Oregon psychiatrists toward
physician-assisted suicide. American Journal of Psychiatry, 153, 1469-1475. Goldblum, P., & Martin, D. (1999).
Principles for the discussion of life and death options with terminally ill clients with HIV. Professional Psychology:
Research and Practice, 30, 187-197.

Grisso, T., & Appelbaum, P. S. (1998). Assessing competence to consent to treatment: A guide for physicians and
other health care professionals. New York: Oxford.

Jamison, S. (1997). Assisted suicide: A decision-making guide for health professionals. San Francisco: Jossey-Bass.

Miller, P. J., Hedlund, S. C., & Murphy, K. A. (1998). Social work assessment at the end of life: Practice guidelines for
suicide and the terminally ill. Social Work in Health Care, 26(4), 23-36.

Muskin, P. R. (1998). The request to die: Role for a psychodynamic perspective on physician-assisted suicide. JAMA,
279, 323-328.

National Association of Social Workers. (1994). Client self-determination in end-of-life decisions. In Social Work
Speaks: NASW Policy Statements (3rd ed.) (pp. 58-61). Washington, DC: NASW Press.

Sanson, A., Dickens, E., Melita, B., Nixon, M., Rowe, J., Tudor, A., & Tyrrell, M. (1998). Psychological perspectives on
euthanasia and the terminally ill: An Australian Psychological Society discussion paper. Australian Psychologist, 33, 1-
11.

Sullivan, M. D., Ganzini, L., & Youngner, S. J. (1998, July/August). Should psychiatrists serve as gatekeepers for
physician-assisted suicide? Hastings Center Report, 28 (4), 24-31.

Veterans Affairs National Center for Cost Containment. (1997). Assessment of competency and capacity of the older
adult: A practice guideline for psychologists. Milwaukee, WI: Author.

Werth, J. L., Jr. (1999a). Mental health professionals and assisted death: Perceived ethical obligations and proposed
guidelines for practice. Ethics and Behavior, 9, 159-183.

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Werth, J. L., Jr. (1999b). Clinical depression and desire for death among persons with terminal illnesses. Social
Pathology: A Journal of Reviews, 5, 22-26.

Werth, J. L., Jr., Benjamin, G. A. H., & Farrenkopf, T. (in press). Requests for physician-assisted death: Guidelines for
assessing mental capacity and impaired judgment. Psychology, Public Policy, and Law.

Werth, J. L., Jr. & Gordon, J. R. (1998). Helping at the end of life: Hastened death and the mental health professional.
In L. Vandecreek, S. Knapp, & T.L. Jackson (Eds.), Innovations in in clinical practice: A source book (Vol. 16) (pp.
385-398). Sarasota, FL: Professional Resource Press.

The Role of Psychology: Introduction

Psychologists can make significant contributions to improve the quality of end-of-life decision-making and care by
actively engaging these issues in the context of practice, education, research, and public policy.

Since psychology as a discipline does not have a strong history of working in the arena of terminal illness, attending
educational programs offered by other disciplines and participating as members of interdisciplinary treatment teams or
research panels are vital strategies for "getting up to speed." These types of collaborations provide psychologists with
partners who have been working in this arena for some time (e.g., medical doctors, nurses, social workers, ethicists,
and chaplains/clergy) while at the same time permitting psychologists to bring their considerable skills and knowledge
to the table for the shared mission of improving the quality of care at the end of life. In this way, psychologists can
learn from those with experience while demonstrating the value of including mental health professionals as active
participants in end-of-life decision-making.

The Role of Psychology: Clinical Roles

With appropriate training, psychologists are particularly suited to carry out clinical roles in assessment, intervention,
advocacy, and interdisciplinary service delivery. Assessment at the end of life includes several areas such as
evaluation of mood and anxiety disorders, pain, family and caregiver interactions, psychological and cognitive
functioning, and existential concerns. Psychologists are also well prepared to plan and implement interventions with
individuals, family members, and providers. They can treat clinical depression if and when it arises in end-of-life
contexts, as well as other mental health problems. Psychologists can provide end-of-life counseling including
facilitating emotional expression, helping caregivers to appreciate the psychological dimensions of the suffering
involved, and being effective listeners and sounding boards for people who are dying, their families and caregivers,
and even their health care providers. Properly trained psychologists can also work effectively with issues of mourning
and loss, traumatic stress, and general objectives for care of dying individuals (Weisman, 1972). They can also serve
as advocates for good medical care along with other professionals (i.e., nurses, social workers, and chaplains).

Equally important is participation of psychologists in hospital ethics committees, palliative care, and other
multidisciplinary teams. Quill and his colleagues (1998) have observed that "Comprehensive, interdisciplinary
palliative care is the standard of care for persons with progressive, advanced disease for whom prognosis is limited
and the focus of medical management is quality of life" (p. 555). In addition, Cummings (1998) has stated that

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the multitude of issues faced by patients and families dealing with a life-threatening illness exceeds the expertise of
any one caregiver. The availability of different team members provides opportunity for support from a number of
sources. The interdisciplinary team...is best equipped to provide a nurturing environment for patient and family. (p. 19)

Assessment Activities

When working with people who are dying, it is essential to assess the overall quality of care they are receiving, to
identify sources of suffering and ways of alleviating them, and to determine what decisions need to be made and who
needs to be involved in making and implementing them. Aside from formal assessment procedures, the mental health
professional working in any clinical role with people at the end of life should keep a number of critical questions in
mind. Answering these questions will require regular consultation with others, including family caregivers, primary care
physicians, nursing staff, pain specialists, oncologists, psychiatrists, ethicists, gerontologists, hospice workers, clergy,
friends, and volunteers. Below are some of the key questions for exploration:

• Is medical care accessible and adequate?

• Are palliative care and pain management adequate?
• Are the psychosocial needs of the dying person, family, and caregivers being addressed?
• Are cultural issues identified and addressed?
• Are spiritual and existential concerns being addressed?
• Is either the physical disease process or the treatment for it creating emotional distress or cognitive
impairment?

Capacity for making health-care decisions may need to be assessed in more detail (Veterans Affairs National Center
for Cost Containment, 1997). To evaluate cognitive status, psychologists working with other members of the treatment
team can determine if impaired cognitive functioning is temporary (e.g., due to delirium, which is common among
older hospitalized persons and may be reversible, once the cause is determined) or if it is due to a more chronic
condition such as dementia. It is important to note that individuals may be competent to make decisions in one area
but not in another (e.g., persons may be able to make valid decisions about their desire to withdraw from a given
treatment regime while not being considered competent to handle their own financial resources) (Grisso, 1986, 1994).
Careful attention must also be given to clinical depression, since it can be difficult to assess in dying persons and yet
have an enormous impact on quality of life and decision-making.

In addition to assessing cognitive status and depression, requests for interventions that might affect the timing of
death should always, independent of legality or the values of the practitioner, be a signal to explore the overall quality
of care. They should also prompt psychologists to explore any feelings that patient may have about being undeserving
of care or a burden to others. The psychologist should explore the psychological, interpersonal, social, spiritual,
economic, gender-related, and cultural reasons behind such requests. Such explorations may reveal areas of unmet
needs or feelings about the self that could suggest a variety of interventions to improve the quality of life. For
example, data suggest that uncontrollable pain is not the primary motive for people who request assisted suicide.
Reasons for requests for both assisted suicide and euthanasia include many nonphysical symptoms such as loss of
personhood, discomfort other than pain, loss of dignity, concern about loss of control, loss of meaning in life, being a
burden, and dependency (Back, Wallace, Starks, & Pearlman, 1996; Canetto & Hollenshead, 1999; Chin, Hedberg,

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Higginson, & Fleming, 1999; Cohen, Fihn, Boyko, & Jonsen, 1994; Coombs Lee & Werth, in press; Ganzini et al.,
2000; Sullivan et al., 2000a, b; Wilson, Viola, Scott, & Chater, 1998).

Suffering at the end of life and requests for assisted suicide and other interventions that may affect the time of death
frequently are associated with clinical depression. It is important to note that older people are less likely to endorse
depressive symptoms or suicidal ideation than younger people with the same level of depression and therefore are
less likely to be recognized as depressed by self-report. Additional complexity is caused by the many serious medical
problems that older depressed individuals tend to have that can make diagnosis a challenge, even for mental health
professionals with special training in this field (Koenig, Meador, Cohen, & Blazer, 1988). The Resource Guide will
contain a more detailed discussion of assessment issues related to depression, dementia, delirium, and decisional
capacity at the end of life. It will identify personal and professional issues that mental health providers should examine
before practicing in this area, including personal values and beliefs, quality and extent of professional training in end-
of-life issues, and ability to make use of consultation and referral.

Clinical & Counseling Activities

It is important to understand that clinical work at the end of life differs from traditional psychotherapy in significant
ways. It can involve advocacy interventions directed toward assuring quality of care, psychoeducational interventions
aimed at improving understanding about dying and death, and systems interventions required to facilitate
communication between the dying individual and his or her family and among the individual, the family, and the
medical team. In addition, clinical work may occur in non-traditional settings (e.g., the home, the hospital, nursing
homes, etc.). Professional boundaries may be more fluid than in traditional psychotherapy cases. For example, it is
common for mental health professionals working with the terminally ill to respond to requests for tangible support - a
drink of water, a special meal, something from the store, etc. Moreover, the focus of clinical work may be less on
insight-oriented psychotherapy (although that can occur), and more on decision-making, emotional coping and
support, existential concerns, and bearing witness at the end of life.

Special themes may arise during counseling with terminally ill people. Within some communities, dying persons and
those who care about them may need help in completing "unfinished business" (Kubler-Ross, 1969), and achieving an
appropriate death (Weisman, 1972). Within these communities, psychologists can help dying persons raise and
resolve issues of meaning in their individual lives through values clarification and/or life review or reminiscence
therapy. Spiritual issues frequently arise when working with dying persons and the exploration of spiritual themes is an
important part of offering support and assisting in the creation of meaning. Because spiritual issues are not often
considered to fall within the domain of psychotherapy, many therapists have limited experience and training in this
area and thus should be alert to the limits of their expertise and make referrals when appropriate. None of the issues
discussed here are universally applicable to all individuals or communities, and the discussion of diversity issues in
Section One of this report should be referred to in this regard.

Other themes that may arise in end-of-life clinical work that distinguish it from traditional psychotherapy include a
heightened emphasis on grief, mourning, loss, and feelings about dying and death, and coping with sorrow,
depression, anger, guilt, and anxiety. Unresolved grief over the earlier deaths of loved ones is likely to arise as some
dying people relive past losses in preparation for losing everything. Fears about dependency, the loss of autonomy,

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control, and dignity are other themes that may arise in counseling dying persons. In addition, being a burden to others
emotionally, physically, or economically are common concerns that may need to be addressed.

Misunderstandings among family and caregivers concerning the nature of anticipatory mourning is also a frequent
theme. Psychologists may reduce the risk of complicated mourning by promoting healthy anticipatory mourning
processes (Rando, 2000) and normalizing anticipatory mourning among family and caregivers. This may include
working with people who have had upsetting images of death, traumatic stress reactions, or post-traumatic stress
reactions following previous losses (the Resource Guide will contain a more extensive discussion of grief, mourning,
loss, and trauma).

Terminally ill people face emotionally charged and symbolic milestones of loss during the course of the dying process.
For example, accepting a feeding tube, or deciding to have a permanent infusion line implanted through which
medications like morphine can be administered on a continuous basis, may represent an important signal to the dying
person that death is becoming more imminent, and may symbolize surrender or acceptance. Other symbolic decisions
that arise include whether to get hospice care, receive care at home, or be in a medical setting of some kind. Each of
these decisions may represent losses that need to be experienced and grieved.

Dying individuals and those close to them may need help with problem solving and decision-making of a more general
nature. Clinicians can help clarify, identify, frame, and articulate choices and priorities. For some, this may include
making sure a will is in order or completing an advance care directive. Psychologists can clarify the purpose and
function of advance directives to help individuals and families discuss advance care planning and also, if necessary,
act as advocates to help ensure that these directives are followed. It is important to note that some communities
regard advance directives with great suspicion because they are viewed as leading to rationed care.

Attending to such details as identifying and designating a responsible guardian or health-care proxy for the dying
person and providing psychological support as the person makes that choice is another task that psychologists can
assume. Some dying individuals may wish to consider what kind of legacy they want to leave, and to plan the kind of
memorialization they want. Even the smallest end-of-life decisions can have meaning and implications that deserve
exploration and emotional support. Ambivalence about many of these decisions is normal, and the clinician can help
people identify the mix of feelings they experience so that they can make thoughtful choices. However, psychologists
working in this arena must bear in mind that in some communities, planning for death is unacceptable or even
considered dangerous.

If the dying person is no longer competent to participate in decision-making because of the effects of the underlying
illness or of various pain medications, the proxy decision-makers acting on the individual's behalf can often benefit
from skilled psychological assistance. The emotional burden of making life and death decisions for a loved one can be
enormous because some decisions are irreversible. There may also be conflict among family members about the best
course of action. Psychologists can play a positive role in clarifying the situation, facilitating discussion, providing
support for the decision-makers, and helping them deal with any residual feelings of guilt or regret over their decision.

A final cautionary note to clinicians working in end-of-life venues is in order. The intensity of working with people who
are dying makes it essential for such professionals to have a strong support system to handle issues of loss, grief,
vulnerability, and traumatization from working so closely with dying and death.

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Advocacy Activities

Dying individuals often have difficulty communicating with health providers about symptoms, fears, and needs, and
psychologists can act as their advocates. Advocacy for quality care for terminally ill individuals and their families may
involve working as part of multidisciplinary teams to ensure that individual needs and quality of life issues are
understood and addressed. Physicians often lack training in end-of-life care and palliative services. Physicians have
been repeatedly shown to under-recognize and under-treat pain and depression in dying individuals (Peruzzi,
Canapary, & Bongar, 1996; Quill et al., 1998). Therefore, psychologists may act as advocates for increased pain
control as well as provide special expertise in assessment of depression (Conwell, Pearson, & DeRenzo, 1996).

Emerging Models of Service Delivery

There are two emerging models of service delivery through which psychologists can make effective contributions to
end-of-life decision-making: functioning as a team member in a hospital or hospice setting and functioning as part of
an ethics committee to provide insights into the psychological aspects of cases being reviewed. Although participation
in hospital ethics committees and multidisciplinary treatment teams is a relatively new role for most psychologists, it is
clear that psychologists can add a unique perspective to health care providers dealing with difficult end-of-life
decisions. For example, informed psychologists can participate in case reviews to facilitate better planning and
decision-making and help to educate hospital staff about psychological aspects of care of dying individuals. They can
also help to coordinate individual and family care. In addition, psychologists can provide expert psychological
guidance to ethics committees struggling with issues of competency and depression. Finally, they can also support
medical staff more directly by helping them to deal with difficult patients or family members as well as supporting them
in dealing with their own feelings around grief, loss, and dying (Block & Billings, 1998; Field & Cassel, 1997).

References

Back, A. L., Wallace, J. I., Starks, H. E., & Pearlman, R. A. (1996). Physician-assisted suicide and euthanasia in
Washington State: Patient requests and physician responses. JAMA, 275, 919-925.

Block, S. D., & Billings, J. A. (1998). Evaluating patient requests for euthanasia and assisted suicide in terminal
illness: The role of the psychiatrist. In M. D. Steinberg, S. J. Youngner (Eds.), End of life decisions: A psychosocial
perspective (pp. 205-233). Washington, DC: American Psychiatric Press.

Canetto, S. S., & Hollenshead, J. (1999). Gender and physician-assisted suicide: An analysis of the Kevorkian cases,
1990-1997. Omega, 40, 165-208.

Chin, A. E., Hedberg, K., Higginson, G. K., & Fleming, D. W. (1999). Legalized physician-assisted suicide in Oregon --
The first year's experience. New England Journal of Medicine, 340, 577-583.

Cohen, J. S., Fihn, S. D., Boyko, E. J., & Jonsen, A. R. (1994). Attitudes toward assisted suicide and euthanasia
among physicians in Washington State. New England Journal of Medicine, 331, 89-94.

Conwell, Y., Pearson, J., & DeRenzo, E. G. (1996). Indirect self-destructive behavior among elderly patients in nursing
homes: A research agenda. American Journal of Geriatric Psychiatry, 4, 152-163.
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Coombs Lee, B. & Werth, J. L., Jr. (in press). Observations on the first year of the Oregon Death with Dignity Act.
Psychology, Public Policy, and Law.

Cummings, I. (1998). The interdisciplinary team. In D. Doyle, G. W. C. Hanks, & N. MacDonald (Eds.), Oxford
Textbook of Palliative Medicine (2nd ed.) (pp. 9-30). Oxford: Oxford University Press.

Field, M. J., & Cassel, C. K. (Eds.). (1997). Approaching death: Improving care at the end-of-life. Washington, DC:
National Academy Press.

Ganzini, L., Nelson, H. D., Schmidt, T. A., Kraemer, D. F., Delorit, M. A., & Lee, M. A. (2000). Physicians' experiences
with the Oregon Death with Dignity Act. New England Journal of Medicine, 342, 557-563.

Grisso, T. (1986). Evaluating competencies: Forensic assessments and instruments. New York: Plenum.

Grisso, T. (1994). Clinical assessment for legal competence of older adults. In M. Storandt & G. VandenBos (Eds.),
Neuropsychological assessment of dementia and depression in older adults: A clinician's guide (pp. 119-139).
Washington,D.C.:American Psychological Association.

Koenig, G. G., Meador, K. G., Cohen, H. J. & Blazer, D. G. (1988). Self-rated depression scales and screening for
major depression in the older hospitalized patients with medical illness. Journal of the American Geriatrics Society, 42,
490-492.

Kubler-Ross, E. (1969). On death and dying. New York: McMillan. Peruzzi, N., Canapary, A., & Bongar, B. (1996).
Physician-assisted suicide: The role of mental health professionals. Ethics and Behavior, 6, 353-366.

Quill, T. E., Meier, D. E., Block, S. D., Billings, J. A. (1998). The debate over physician-assisted suicide: Empirical
data and convergent views. Annals of Internal Medicine, 128, 552-558.

Rando, T. A. (Ed.) (2000). Clinical dimensions of anticipatory mourning: Theory and practice in working with the dying,
their loved ones, and their caregivers. Champaign, IL: Research Press.

Sullivan, A. D., Hedberg, K., & Fleming, D. W. (2000a). Oregon's Death with Dignity Act: The second year's
experience. Portland, OR: Oregon Health Division.

Sullivan, A. D., Hedberg, K., & Fleming, D. W. (2000b). Legalized physician-assisted suicide in Oregon -- The second
year. New England Journal of Medicine, 342, 598-604.

Veterans Affairs National Center for Cost Containment. (1997). Assessment of competency and capacity of the older
adult: A practice guideline for psychologists. Milwaukee, WI: Author.

Wilson, K. G., Viola, R. A., Scott, J. F., & Chater, S. (1998, April). Talking to the terminally ill about euthanasia and
physician-assisted suicide. Canadian Journal of Clinical Medicine, 68-74.

Weisman, A. (1972). On dying and denying: A psychiatric study of terminality. New York: Behavioral Publications.

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The Role of Psychology: Education and Training Roles

Education of the Profession

Since psychology does not have a strong history of working in the arena of terminal illness and end-of-life decision-
making, the discipline will need to focus on self-education first. As mentioned previously, attending educational
programs offered by other professions and participating in interdisciplinary treatment teams or research panels are
vital strategies for bringing the profession "up to speed." The field of thanatology (the study of dying, death, and
bereavement) is essentially a multidisciplinary area of study and those wishing to specialize in it should be receptive
to learning from a variety of professionals. There are, however, a significant number of psychologists who have
attained stature as authorities in this field and they may be in a position to serve as teachers and mentors. It is
essential for end-of-life issues to be integrated into existing undergraduate and graduate courses (Abeles & Barlev,
1999; International Work Group on Death, Dying, and Bereavement, 1991). Free-standing courses in the psychology
of dying and death can also be added to both undergraduate and graduate curriculum.

Content areas for these courses could include: the demographics of aging and dying; the process of dying; loss,
mourning, and grief; attitudes toward dying and death; quality of life issues; needs of the dying, their loved ones, and
their caregivers; understanding the culture of the medical setting; ethical issues involved; quality of care issues; the
importance of ritual at the end of life; gender and diversity issues in end-of-life care and decision-making; incidence
and effects of depression, dementia, and delirium at the end of life; and clinical training in assessment of people at the
end of life. Integration across the curriculum of gender and diversity issues and exposing students to a variety of
social and cultural groups in their practica should occur at every level. Practical experience can be offered to students
through supervised practica and internships in hospitals, nursing homes, hospices, and home health care agencies.
Supervised practical experience can also be gained through illness-focused agencies, illness and bereavement
groups, and mental health agencies serving relevant populations. Extracurricular activities planned through Psi Chi or
a Psychology Club can provide additional exposure.

Professional education and training in end-of-life issues is different from training in standard counseling and
psychotherapy techniques both in style and in content. As noted above, clinical work with people at the end of life is
typically more short-term and interactive and it involves more advocacy than other kinds of counseling. Educational
methods should also include values clarification and self-exploration of personal attitudes toward death (Stillion, 1983,
1999).

Education of the Public

As more psychologists become knowledgeable about working with people making end-of-life decisions, they can
make significant contributions to the public dialogue about death and dying. Psychologists, along with other health
care providers, can appear on panels dealing with decision-making. They can work with the media, prepare
publications, videos, and other psychoeducational materials. They can also encourage discussion about dying and
death with clients and their family members when culturally appropriate.

People need knowledge in order to communicate effectively with health care providers. Psychologists can help people
understand loss, grief, and mourning; explain the concept of traumatic stress in response to difficult deaths and
losses; and help understand differences between normal sadness and clinical depression at the end of life. They can
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teach people to be more aware of unique individual needs and assumptions about dying and death. They can identify
common problem areas for families, significant others, or intimates facing death, encourage values clarification around
end-of-life issues, provide information about advance care planning and how to implement it, clarify issues involved in
difficult end-of-life decisions, and teach coping mechanisms. They can raise awareness of when or how sexism,
ageism, ethnocentrism, and ableism influence end-of-life planning and decision-making, and of the social and cultural
pressures that may result in some groups and individuals being devalued.

References

Abeles, N. , & Barlev, A. (1999). End-of-life decisions and assisted suicide. Professional Psychology: Research and
Practice, 30, 229-234.

International Work Group on Death, Dying, and Bereavement. (1991). A statement of assumptions and principles
concerning education about death, dying, and bereavement. Death Studies, 16, 59-65.

Stillion, J.M. (1983). Where thanatos meets eros: Parallels between death education and group psychotherapy. Death
Education, 7, 53-67.

Stillion, J. M. (1999). Rational suicide: Challenging the next generation of caregivers. In J. L. Werth, Jr. (Ed.),
Contemporary Perspectives on Rational Suicide (pp. 160-167). Philadelphia: Taylor & Francis.

The Role of Psychology: Research Roles for Psychologists

The third area in which psychologists can play an important and productive role in improving care at the end of life has
to do with planning and conducting research. The quality and amount of existing research on end-of-life decision-
making is limited. Therefore, there are multiple opportunities for extending behavioral and psychological knowledge
about dying and about decisions that may affect the timing of death.

Ethical and Methodological Issues

A word of caution is in order. There are ethical issues involved in research with people at the end of life. Persons who
are seriously sick and dying are a psychologically vulnerable population at risk for exploitation. For example, dying
persons may experience fluctuating patterns of cognitive impairment, which may require investigators to reexamine
informed consent and participation in research. Another ethical issue has to do with the fact that participation in
research may interfere with care and add stress to people whose energy level and sense of wellbeing may be fragile.
On the other hand, there are possible benefits and rewards derived from participation in research. Potential benefits
include a sense of altruism, a value that may be important for persons at the end of life, as well as receiving the
attentive care and state-of-the-science monitoring that is often associated with a clinical trial of a new care program.

There are a variety of methodological problems associated with much of the existing research having to do with end-
of-life issues (Rosenfeld, in press). For example, many studies have had one or more of the following design
limitations: (a) dependent variables of questionable utility (e.g., hypothetical questions about some future possible
scenario), (b) sample selection bias (e.g., participants are either not terminally ill or, if they are, they are closely
screened so the results are non-generalizable), and (c) study site bias (e.g., palliative care centers provide convenient

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samples but most people do not go through the dying process in such places). Another methodological difficulty
associated with end-of-life research has to do with the fact that symptoms associated with the illness and/or the
medications to alleviate those symptoms may interfere with the ill person's ability to actively participate in the study or
remember information accurately. One strategy to ameliorate this limitation is to interview significant others in addition
to the dying person.

Priority Areas for Future Research

1. There is no common lexicon of terms to describe key events and phenomena at the end of life. Therefore,
researchers from a variety of disciplines should work toward the development of a consensus on key terms
and concepts related to dying and death. Such collaboration could provide a basis for developing theories
and advancing knowledge that would be more readily utilized and understood by professionals in all
disciplines involved.
2. There is little documentation about the ways in which the people live the last phase of life and die. Normative
research should focus on emotions, cognitions, behaviors, and attitudes of dying persons as well as on
interactions between dying persons, family members, and professional caregivers engaged in end-of-life
decisions. Research on normative experiences could also examine the role of psychological, social,
cognitive, and behavioral factors associated with common problems at the end of life. This could include the
study of psychological issues in pain and suffering, studies of the prevalence of neuropsychological
symptoms in persons suffering from different diseases, and studies of the prevalence of depression and
delirium in persons with advanced medical diseases. It should also include the study of family dilemmas and
responses to a dying person.
3. It is important to determine how the dying experience and the meaning of dying differs in relation to diversity
factors such as gender, sexual orientation, education, and cultural group membership.
4. Research to develop or refine assessment instruments for older, sick, and/or dying persons is needed. Less
taxing measures of depression, decision-making capacity, and quality of life should be developed with
sensitivity to diversity issues among sick, older, and dying populations.
5. Research on optimal end-of-life experiences is also needed. It is important to understand how people want to
live the last phase of their lives and the conditions that they believe will lead to an appropriate death for
them. Researchers should be looking at the variability of views depending on gender, ethnicity, sexual
orientation, age, education, income, religious background, living arrangements, and family structure.
6. Research to determine the adequacy of palliative care and the psychological effects of rationing health care
on persons of limited means and their families is needed. For example, does such rationing increase the
likelihood that such persons will request an intervention that may affect the time of death?
7. We know very little about the availability and quality of psychological services for persons in the last phase of
life and their families. Research to discover the extent, timing, type, and delivery modes of psychological
services in use by dying persons and their families at the present time is in order.
8. Outcome evaluations concerning existing psychological services are also necessary. This area of research
may include surveys of current forms and uses of psychological services as well as the exploration of optimal
psychological services that could or should be available. Research is also needed to investigate barriers to
quality psychological care (i.e. attitudinal, organizational, legal, cultural, economic, and other factors that
impede the application of existing knowledge and principles of psychological care).

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 9. Research on the relative efficacy of various models of training health and mental health care providers to
work successfully with dying patients and their families is needed.
10. Research on the psychosocial interactions of dying persons is also needed. This would include how they
interact with caregivers and families regarding decisions for care, and the variability of those interactions
depending on sex, ethnicity, age, sexual orientation, education, religious background and practice of the
dying person, the primary family caregiver, and the primary professional caregiver.
11. The effect of caregiver burden on end-of-life decisions is another fruitful area for research. At what point, if
any, in the dying process are caregivers likely to consider interventions that may shorten life for their loved
ones and what variables contribute to these thoughts?
12. The entire area of psychological, interpersonal, medical, social, and existential concerns that underlie
requests for interventions that may affect the time of death needs definitive research. In addition, the
responses of family and professional caregivers to such requests need examination, as does the effect of
their responses on the dying person.
13. Ethical issues in research involving those who are dying and their families need to be examined and
articulated in a systematic way.
14. There is currently an opportunity to conduct research on assisted suicide itself. Where assisted suicide is
legal, psychological autopsy studies of assisted suicide cases could be carried out. It is also important to
study factors that distinguish the following groups of individuals: (a) dying persons who do not request
assisted death; (b) dying persons who only express an interest in it; (c) dying persons who request it but do
not go through it; and, (d) dying persons who actually carry out assisted suicide.
15. Where assisted suicide is legal or decriminalized, it is important to determine how its availability affects
anxiety and comfort levels about the end of life among older people, the terminally ill, and the disabled.
Further, does the availability of assisted suicide affect the timing of death (i.e., do people die sooner than
they would have if this action was not available or does its availability result in people staying alive longer
with the knowledge they can make decisions about the timing of death)? What is the impact of any policy
changes on devalued and disadvantaged groups should be monitored.

References

Rosenfeld, B. (in press). Methodological issues in assisted suicide/euthanasia research. Psychology, Public Policy, &
Law.

The Role of Psychology: Policy Roles

The report of the Institute of Medicine (IOM) Committee on Care at the End of Life (Field & Cassel, 1997) identified
five broad areas of deficiencies in current care for people with life-threatening and incurable illnesses. Each of these
five areas present numerous opportunities at federal, state, and local levels for psychologists who are interested in
playing advocacy or policy roles to advance the quality of care at the end of life.

First, many people suffer needlessly at the end of life. Sometimes suffering arises when caregivers fail to provide
palliative and supportive care known to be effective (e.g., appropriate treatment of pain and depression;
pharmacological, compensatory, and environmental interventions to address dementia and other forms of cognitive
impairment; individual and family counseling to facilitate communication about needs and expectations associated
with end-of-life care; etc.). At other times, suffering arises when the aggressive use of ineffectual or intrusive
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interventions serves to prolong the period of dying unnecessarily or to dishonor the dying person's wishes about care.
Too often, dying people and their families are either not aware of these care options, not fully apprised of the probable
benefits and burdens of these various options, or are the recipients of care that is inconsistent with their wishes as
expressed in written or oral directives. Psychologists can join other health care professionals in advocating for the
development of public, institutional, and organizational policies to ensure that individuals and families know what
types of interventions and services are available to them; understand what types of outcomes they can reasonably
expect from such services and interventions; and receive end-of-life care that is consistent with their values, beliefs,
and wishes.

Suffering can also be reduced by advocacy aimed at encouraging health care institutions to adopt mechanisms for
monitoring and evaluating end-of-life care from the perspective of individuals and families. As Field and Cassel (1997)
point out, many commonly used physiological and functional indicators of quality of care are not linked to outcomes as
experienced by persons and families. Psychologists can play a critical role in encouraging hospitals and other health
care institutions to develop and utilize quality of care measurements that are: (1) relevant to the experiences of dying
individuals and those close to them; (2) sensitive to the effects of changes in care; and (3) efficient and practical to
use.

A second area of deficiency cited by the IOM Report has to do with the numerous legal, organizational, and economic
obstacles that interfere with quality care at the end of life. Outdated drug-prescribing laws, burdensome regulations,
and problematic medical board policies often intimidate physicians and other professionals who wish to relieve their
patients' pain but are unable to do so because of scrutiny from regulatory boards and committees that frequently fail to
understand either modern techniques for pain management, or the psychological and behavioral distinctions between
drug tolerance and physical dependence on the one hand, and addiction on the other. In addition, fragmented
organizational structures often complicate the coordination of care and reduce the likelihood that individuals and
families will access various types of support services that are essential elements of quality care. This is especially true
with respect to accessing psychological and psychoeducational services that are rarely integrated with primary care.
Psychologists can play an important role in advocating for systemic changes in these types of legal and organizational
obstacles to quality care.

Because over 70% of those who die every year are covered by Medicare (Field & Cassel, 1997), economic obstacles
to quality end-of-life care largely arise from the nature and quality of Medicare benefits. A major concern about
Medicare's hospital payment policies is that they encourage premature patient discharge and discourage appropriate
inpatient palliative services. Since the 1980s, Medicare has used a prospective payment scheme that pays for most
hospital stays on the basis of diagnosis-related category or group (DRG). If hospitals spend less than the
prospectively-determined DRG payment, they keep the difference. They are not routinely compensated if they spend
more. Thus, there is an incentive to both limit hospital stays and limit inpatient support and palliative services. These
incentives may be particularly devastating to dying people who are among the sickest of Medicare beneficiaries with
the most complex psychological and psychosocial needs. In this context, it is often difficult to adequately address and
coordinate palliative and psychosocial support care prior to discharge. Advocacy is needed to modify payment
categories and payment levels to ensure that there are resources to support a coordinated inpatient, interdisciplinary
team that includes psychologists and other professionals skilled in addressing psychological and psychosocial needs.

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Medicare coverage for hospice services is unfortunately quite limited. To qualify for Medicare hospice benefits,
individuals must be certified as having a life expectancy of six months or less if the illness runs its natural course.
Thus, the hospice benefit is not applicable to many people with serious illness with an uncertain course. A major
limitation of the home health benefit of hospice services has to do with the fact that beneficiaries must either be
homebound and need part-time or intermittent skilled nursing care or they must require physical or speech therapy.
Some dying individuals would benefit significantly from home palliative care before they become completely
homebound.

Yet another primary concern about Medicare's payment scheme is that its payment categories and payment levels for
outpatient support services may not appropriately recognize the time and resources required to care well for the
complex psychological and psychosocial problems presented by people with advanced disease that is expected to
prove fatal. For example, it is often necessary for psychologists and other outpatient providers to meet with individuals
and families in the home or in the hospital. It is also necessary to meet with other professionals in order to coordinate
care. Unfortunately, traditional financing mechanisms pay for circumscribed procedural services (e.g., 50-minute
session of psychotherapy) but not the actual time required for home and hospital visits, the time devoted to
coordinating care with other professionals; the time required for the thorough and ongoing assessment of individual
and family needs; or the time involved with psychoeducational interventions for persons, families, and other
healthcare providers that are so critical for quality end-of-life care. Advocacy is desperately needed for the
development of Medicare reimbursement policies that promote holistic and coordinated care.

A third major area of deficiency cited in the IOM Report has to do with the fact that the education and training of
psychologists, physicians, and other health care professionals fail to provide them with the attitudes, knowledge, and
skills required to care well for dying people and their families. As Field and Cassel (1997) point out, current
deficiencies in practice basically stem from prior failures in professional education. Advocacy is needed to encourage
the allocation of federal funds to establish comprehensive programs of undergraduate, graduate, and continuing
education. These programs should prepare psychologists and other health professionals to understand and manage
their own reactions to dying and death, to deliver science-based interventions that are responsive to the needs of
individuals and families, and to communicate sensitively and effectively with dying people and those close to them.
Because quality end-of-life care is predicated on effective teamwork and coordination, it is critical that professional
education programs utilize multidisciplinary approaches to training that prepare professionals involved in end-of-life
care to participate effectively in multidisciplinary care teams organized to assist individuals and families at the end of
life.

A fourth area of deficiency that suggests the need for advocacy and policy change has to do with the level and type of
funding available for social, behavioral, and health services research dealing with end-of-life issues. The preceding
section of this report outlines many areas in need of investigation. However, these areas are unlikely to be pursued
without leadership from Congress as well as key officials at federal agencies responsible for directing research
funding for behavioral and biomedical sciences. Advocacy is needed to encourage the National Institutes of Health
(NIH), the Health Resources and Services Administration (HRSA), the Health Care Financing Administration (HCFA),
the Agency for Healthcare Research and Quality (AHRQ), the National Center for Health Statistics (NCHS), and other
federal agencies to provide leadership in organizing workshops, consensus conferences, and other initiatives that
serve to clarify what is known, what is not known, what areas are of highest priority, and what types of funding
mechanisms are most likely to support the rapid development of knowledge.

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As knowledge from basic research develops, advocacy will also be needed to ensure that Congress and relevant
federal agencies support the application, dissemination, and transfer of new information through funding for
demonstration projects to test new models, funding for the development of clinical practice guidelines designed to
promote the replication of proven interventions, and funding for national continuing education programs designed to
get the word out to professionals in the field. Additionally, advocacy is needed to encourage NIH and other biomedical
research groups to gather information about death, dying, and end-of-life care in the context of current clinical trials
associated with potentially fatal diseases.

A fifth area of deficiency around which advocacy and policy efforts could be organized has to do with the reality that
most people in this country have not yet learned how to confront and discuss the topic of death and dying in an open
and effective manner even when their culture or religion does not consider this a taboo subject. Psychologists are in a
unique position, by virtue of their recognized expertise in facilitating the exploration and examination of emotionally
charged issues, to promote open discussions about death and dying with individuals and with other professionals.
Psychologists are also uniquely qualified to advocate for the ongoing discussion of these topics in the media, in the
community, and in professional meetings.

A final area of deficiency that could become the focus of advocacy efforts has to do with the fact that there is often
inadequate care for people with disabilities (National Council on Disability, 1998). Unfortunately, popular beliefs
among the non-disabled that they would rather be dead than disabled sometimes combine with the medical industry's
emphases on cost savings and leads to decisions to withhold crucial services from patients with severe disabilities.

References

Field, M. J., & Cassel, C. K. (Eds.). (1997). Approaching death: Improving care at the end-of-life. Washington, DC:
National Academy Press.

National Council on Disability (1998). Assisted suicide: A disability perspective. Issues in Law and Medicine, 14, 273-
300.

Historical Changes Affecting Care

In 1900, the average lifespan was 47.3 years; by 1997 it had increased to 76.5 years, a gain of 29.2 years in less than
a century (Kramarow, Lentzner, Rooks, Weeks, & Saydah, 1999). This overall gain in length of life obscures important
differences in longevity across demographic groups. For example, women currently live seven years longer than men
do. Among those 85 and older, there are five women for every two men (Bureau of the Census, 1996). An African
American woman can expect to live 74 years, compared to 80 years for a European American woman. The estimated
life expectancy at birth for African American men is 65 years, as compared to 73 for European Americans (Field &
Cassel, 1997). Social class factors, including income and education levels, also affect longevity.

The age distribution of the population in the United States has changed substantially in this century. The number of
persons under age 65 has tripled in this period of time while the number of persons 65 or over has jumped by a factor
of 11 (Bureau of the Census, 1996). It is particularly noteworthy that the rate of aging of the population is expected to
accelerate for the next half century. In 1994, one in every eight persons in the United States was over 65. By the year
2050, the older adult population is expected to more than double, resulting in a ratio of one older adult to five younger

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persons. The "old-old," those 85 and over, are the most rapidly growing sector of the aged. By the year 2050, people
over 85 are expected to make up 24% of older persons and 5% of the entire population in the United States,
numbering over 19 million. Today, three-fourths of those who die annually are older adults. Assuming continued
increases in longevity, the proportion of those who die past age 75 will also increase (Field & Cassel, 1997).

The causes of death have also changed dramatically. In 1900, the ten leading causes of death were pneumonia,
tuberculosis, diarrhea and enteritis, heart disease, stroke, liver disease, injuries, cancer, senility, and diphtheria
(Centers for Disease Control and Prevention, 1999). Most people died from infectious illnesses that caused death with
certainty and relative rapidity. By 1998, the ten leading causes were heart disease, cancer, stroke, chronic lung
disease, pneumonia and influenza, accidents, diabetes, suicide, kidney disease, and chronic liver disease (Martin,
Smith, Mathews, & Ventura, 1999). Thus, the contemporary list includes only two causes of death (accidents and
suicide) that lead to a quick death. It has been estimated that 70-80% of people in advanced industrial nations now
face death later in life from chronic or degenerative diseases characterized by late, slow onset and extended decline
(Battin, 1996).

The location where death typically occurs has also changed, moving from the home to technologically sophisticated
and often impersonal settings. It has been estimated that in the United States nearly 60 percent of all deaths occur in
hospitals or medical centers. Another 16 percent occur in other institutions, such as nursing homes or hospices
(Benoliel & Degner, 1995). Only a minority of people die in the care of formal hospice programs, and the majority of
these hospice deaths involve cancer diagnoses. More recently, the proportion of those who die at home has begun to
increase because changes in Medicare benefits have led to increased availability of home hospice services (Field &
Cassel, 1997).

The timing of an individual's death has also changed. As the dying process and death have moved from taking place
at home to medical settings, professionals have exerted more control over the timing of dying. Technology now
permits life to be greatly extended. It appears that in a growing number of terminal cases medical decisions are made
to withhold or withdraw treatment (Field & Cassel, 1997).. In 1992, it was estimated that 70 percent of the 6,000
deaths that occur daily in the United States are somehow timed or negotiated with family, doctors, and the dying
person when competent, quietly agreeing to not use death-delaying technology (In re L.W., 1992).

Scientific advances in medicine have produced an expanded array of interventions that present individuals, families,
and health care professionals with an increased number of very difficult decisions about the timing and course of the
dying process. This change has resulted in an expanded role for bioethical review teams in many clinical settings. In
1983, one percent of all medical facilities in the United States had ethics committees and/or multidisciplinary teams
that served to oversee difficult medical decisions. By 1993, the American Hospital Association estimated that 60-85%
of hospitals had ethics committees (Webb, 1997).

The life-extending potential of medical interventions has also led to the development of a whole new body of end-of-
life laws. All 50 states have addressed end-of-life issues either by legalizing some form of advance directive or by
enacting alternative provisions for end-of-life decisions in the form of family consent, surrogacy, or succession laws
that do not require a document to be signed prior to loss of competence. Although it is beyond the scope of this report
to detail all of the changes in end-of-life legislation, three recent legal developments are worth noting because they
have widespread significance for end-of-life care and they continue to be the focus of high-profile debates in both

147
politics and the press. One is The Oregon Death with Dignity Act, which was first implemented in 1997 and permits
physician-assisted suicide under limited, carefully specified conditions. The second one are the rulings of the U.S.
Supreme Court, in June of 1997, that there is no constitutional right to physician-assisted suicide and that states are
free to decide whether they wish to legalize this practice (Vacco v. Quill, 1997; Washington v. Glucksberg, 1997). The
last one is The Pain Relief Promotion Act, introduced in the United States Congress in 1999. If enacted, funding for
training in palliative care would be provided but physicians would be in violation of the Federal Controlled Substances
Act if they prescribed or administered opioids, barbiturates, or other controlled medications with the purpose of
helping a person to die. Thus, passage of The Pain Relief Promotion Act would functionally negate the Oregon law
and prohibit other states from enacting similar laws.

Changes in public attitudes about participation in medical decision-making and about seeking help from mental health
professionals are likely to produce corresponding changes in expectations about end-of-life care. In the past two
decades, there has been an increased demand by individuals and families for active participation in medical decision-
making, especially among well-educated and middle class populations. With the coming of age of the baby boom
generation, larger numbers of people in the United States have come to accept mental health services as an
important resource for dealing with difficult decisions and emotionally challenging situations. These shifts in attitude,
combined with the fact that the baby boom generation is increasingly dealing with end-of-life care for their parents and
the prospect of their own mortality, suggest the likelihood of an increasingly sophisticated demand for psychosocial
services in dealing with end-of-life decisions.

References

Battin, M. P. (1996). The death debate: Ethical issues in suicide (pp. 175-203). Upper Saddle River, NJ: Prentice-Hall.

Benoliel, J .Q. & Degner, L. F. (1995). Institutional dying: A convergence of cultural values, technology, and social
organization. In H. Wass & R. A. Neimeyer (Eds.) Dying: Facing the facts (pp. 117-141). Washington, DC: Taylor and
Francis.

Bureau of the Census, U.S. Department of Commerce, Economics and Statistics Administration (1996). Sixty-five plus
in the United States. (Current population reports, special studies, 23-100). Washington, DC: U.S. Government Printing
Office.

Centers for Disease Control and Prevention (1999, July 30). Control of infectious diseases. Morbidity and Mortality
Weekly Report, 48(29), 621-629.

Field, M. J., & Cassel, C. K. (Eds.). (1997). Approaching death: Improving care at the end-of-life. Washington, DC:
National Academy Press.

In re L.W., 482.N.W.2d 60 (Wis. 1992).

Kramarow, E., Lentzner, H., Rooks, R., Weeks, J., & Saydah, S. (1999). Health, United States, 1999 with health and
aging chartbook. Hyattsville, MD: National Center for Health Statistics.

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Martin, J. A., Smith, B. L., Matthews, T. J., & Ventura, S. J. (1999). Births and deaths: Preliminary data for 1998.
National Vital Statistic Reports, 47(25), 1-48.

Vacco v. Quill, 117 S.Ct. 2293 (1997).

Webb, M. (1997). The good death: The new American search to reshape the end of life. New York: Bantam.

Washington v. Glucksberg, 117 S.Ct. 2258 (1997).

Issues of Access and Variability in Health Care

The national debate about end-of-life care typically focuses on choices about treatment options and about who has
the right or expertise to make the choices. This debate assumes that people have options about their care. Although
the medical system in the United States offers excellent care choices, the options are largely available only for those
who have money or are insured. Individuals who do not have access to private health care insurance often suffer from
insufficient and/or poor quality care. Most of the uninsured are older women, children, and ethnic minorities. Access to
life-extending medical technology is similarly a function of resources. Higher income individuals are more likely to
have a private attending physician, which is related to maintenance of life-sustaining care (Mishara, 1999). As noted
by Field and Cassel (1997), "people may have the theoretical right to make their own medical choices, but many do
not have the financial access to minimal care necessary for implementation of those choices" (p. 48). It should be
noted that concerns about costs also influence the preferences of individuals and family members about life-extending
measures (Covinsky et al., 1996).

Even when dying people have access to medical care, the quality of care is highly variable and less than desirable.
The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT Principal
Investigators, 1995) conducted from 1989 to 1994 is the most massive research effort to date associated with the
process of dying in America. The study tracked some nine thousand people with various serious and terminal
illnesses during the final stages of their life. It also included a large slice of the medical establishment, involving
interviews with some 1600 physicians, 500 nurses, and many other health care professionals at numerous prestigious
medical institutions. In Phase I of the study, researchers examined how people were treated when they entered the
hospital, how medical decisions were made, and what happened to them and their families during the acute treatment
period and for six months afterward. Findings from the study were quite dramatic:

• Half of the people who were still conscious had moderate to severe pain at least half of the time before they
died;
• More than half of the doctors in the study did not know about their patients' preferences for life-sustaining
treatment;
• Nearly 40% of the individuals spent at least 10 days in an intensive care unit.

In Phase II of the study, a number of interventions were put in place that a large panel of experts on end-of-life
medicine and law thought would change treatment patterns and make the process of dying more comfortable. In the
end, those patients who received the interventions were treated the same as those patients for whom no such efforts
were made.

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References

Covinsky, K. E., Landefeld, C. S., Teno, J., Connors, A. F., Jr., Dawson, N., Youngner, S., Desbiens, N., Lynn, J.,
Fulkerson, W., Reding, D., Oye, R., & Phillips, R. S. (1996). Is economic hardship on the families of the seriously ill
associated with patient and surrogate care preferences? Archives of Internal Medicine, 156, 1737-1741.

Field, M. J., & Cassel, C. K. (Eds.). (1997). Approaching death: Improving care at the end-of-life. Washington, DC:
National Academy Press.

Mishara, B.L. (1999). Synthesis of research and evidence on factors affecting the desire of terminally ill persons to
hasten death. Omega, 39, 1-70.

SUPPORT Principal Investigators. (1995). A controlled trial to improve care for seriously ill hospitalized patients: The
Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT). JAMA, 274,
1591-1598. [Erratum, JAMA, 275, 1232 (1996).]

Diversity Issues in Decision-Making

In the United States, the dominant discourse about illness, dying and death focuses on autonomy, independence,
self-control, and individual choice. The health care system reinforces this individualistic focus through the legal
structures of advance directives and informed consent. This focus on the individual and on planning for death
presupposes a particular situation and assumptive world that include the following elements:

• the individual is the primary decision-maker;

• the individual has an interest in being in charge;
• there is a clear communication and understanding between the individual and the medical team about
diagnosis, prognosis, and options;
• the individual has equal financial access to the different options offered;
• the individual has the power and sense of entitlement to make whatever choice is desired;
the individual is competent to make choices;
• the individual values discussing and planning for death;
• the individual has a spiritual orientation that does not emphasize divine interventions, and allows for choice in
time and manner of death (Koenig, 1997).

There are many people in the United States for whom at least some of these conditions do not pertain. The model
above is particularly inadequate to account for the experiences and values of persons who are in one way or another
culturally different or socially disadvantaged. This includes ethnic and religious minorities for whom individual
decision-making is not a priority. Persons who are economically disadvantaged also do not fit the conditions of an
end-of-life model that assumes equal access to different options. The same may be true of persons with disability. In
fact, a social or minority model for conceptualizing disability may be more suitable than the medical model because
many of the barriers that confront disabled people are of social origin, involving widespread devaluation of this
particular form of diversity.

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Social and cultural groups vary with regard to beliefs and opinions regarding end-of-life decision-making. This
includes the appropriateness of talking about and planning for death, informing persons that they are dying, and the
roles of the individual, family members, and physicians regarding end-of-life decisions. These groups also vary in
even more basic dimensions (such as orientation to the future, conceptions of the self and personhood, and beliefs
about the rights of the individual) that may have implications for end-of-life decision-making. In addition, individual
differences within social groups can be as great as, or greater than, differences between groups because individuals
are often exposed to multiple and sometimes contradictory systems of values. Similarly, individuals from the same
demographic group do not all think the same way. Another variable is that group experiences and the system of
values affecting attitudes and behavior are not fixed. Rather they are constantly evolving within specific social and
historical contexts. Finally, diversity factors do not apply to minorities only, and are relevant not only to individuals and
their families, but also to professional care providers (Koenig, 1997). Diversity considerations are therefore critical in
developing a psychological agenda for end-of-life issues, especially in a demographically diverse and socially
stratified country like the United States.

A diversity perspective shows that the ethical and practical questions that have dominated the national debate on the
end of life are not universal concerns. For example, persons of Chinese descent may place a value on protecting the
dying person from negative information (Hallenbeck, Goldstein, & Mebane, 1996), and therefore may not discuss
impending death with the dying person. Similarly, family dynamics in recent immigrants from Mexico or Korea may
tolerate less individual autonomy than is permitted in families of European or African descent that have not recently
immigrated (Field & Cassel, 1997). In addition, in many cultural and religious traditions, there may be an expectation
that women rely on the authority and advice of male authorities (e.g., family members, professionals, etc.) for
decision-making. In some traditions, there may also be an expectation of women's self-sacrifice (Wolf, 1996). Further,
planning about dying is contrary to traditional Navajo values, particularly the value of "avoiding thinking or speaking in
a negative way ('doo'ajÌniidah')" (Carrese & Rhodes, 1995, p. 828). In this tradition, discussion of negative information
is harmful in that it may bring about a feared negative outcome. Finally, among some ethnic minorities, longevity may
be an intrinsic good, independent of health status.

Studies have found that African Americans and Hispanics are more likely than European Americans to express a
preference for life-sustaining treatment, regardless of the state of the disease, and independent of educational level
(Caralis, Davis, Wright, & Marcial, 1993; Morrison, Zayas, Mulvihill, Baskin, & Meier, 1998). These preferences may
be related to negative experiences with the medical system (including inadequate care, as well as difficulties in
negotiating their needs), leading to a lack of trust in professional advice (Hallenbeck et al., 1996; Koenig, 1997).

Further examples of diverse positions that are socially based include people in the disability community, who express
serious concern about sanctioning assisted suicide. A common attitude among the non-disabled indicates that some
would rather be dead than disabled, which, taken in the context of medical-industry emphasis on cost savings, could
lead to withholding critical services to people with disabilities. Such concerns regarding the effects of devaluation and
cost-saving strategies are also highly relevant to other disenfranchised groups such as people suffering from alcohol
and drug abuse or dependence.

Issues of social, economic, and cultural diversity become even more critical in decisions that may affect the timing of
death. In the United States, no matter how carefully any safeguards are framed, such decisions are practiced in a
context of social inequality, bias, and unequal access to services. In regard to assisted suicide and euthanasia, it has

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been argued that the persons who are the most vulnerable to coercion or abuse are those "whose autonomy and well-
being are already compromised by poverty, lack of access to good medical care, or membership in a stigmatized
social group" (New York State Task Force on Life and the Law, 1994, pp. vii-viii). This argument has been extended to
include all types of end-of-life decisions (Canetto & Hollenshead, 1999; Orentlicher, 1997). Older persons, women,
religious and ethnic minorities, sexual minorities, and persons with disabilities who are seriously ill, may be particularly
likely to be perceived as burdensome by the medical system. Furthermore, they may also have a lower sense of
entitlement to resources, and may come to see themselves as appropriate candidates for an accelerated death.

References

Canetto, S. S., & Hollenshead, J. (1999). Gender and physician-assisted suicide: An analysis of the Kevorkian cases,
1990-1997. Omega, 40, 165-208.

Caralis, P. V., Davis, B., Wright, K., & Marcial, E. (1993). The influence of ethnicity and race attitudes toward advance
directives, life-prolonging treatments, and euthanasia. Journal of Clinical Ethics, 4, 155-165.

Carrese, J. A., & Rhodes, L. A. (1995). Western bioethics on the Navajo reservation. JAMA, 274, 826-829.

Field, M. J., & Cassel, C. K. (Eds.). (1997). Approaching death: Improving care at the end-of-life. Washington, DC:
National Academy Press.

Hallenbeck, J., Goldstein, M. K., & Mebane, E. W. (1996). Cultural considerations of death and dying in the United
States. Clinics in Geriatric Medicine, 12, 393-406.

Koenig, B. A. (1997). Cultural diversity in decisionmaking about care at the end of life. In M. J. Field, & C. K. Cassel
(Eds.), Approaching death: Improving care at the end-of-life (pp. 363-382). Washington, DC: National Academy Press.

Morrison, R. S., Zayas, L. H., Mulvihill, M., Baskin, S. A., & Meier, D. E. (1998). Barriers to completion of health care
proxies: An examination of ethnic differences. Archives of Internal Medicine, 158, 2493-2497.

New York State Task Force on Life and the Law (1994). When death is sought: Assisted suicide and euthanasia in the
medical context. Albany, NY: Health Education Services.

Orentlicher, D. (1997). The Supreme Court and physician-assisted suicide: Rejecting assisted suicide but embracing
euthanasia. The New England Journal of Medicine, 337, 1236-1239.

Wolf, S. M. (1996). Gender, feminism, and death: Physician-assisted suicide and euthanasia. In S. M. Wolf (Ed.),
Feminism and bioethics: Beyond reproduction (pp. 282-317). New York: Oxford University Press.

Terminology, Definitions, and Other Barriers to Communication

Discussions about end-of-life issues can be difficult for many reasons. First, dying and death are not openly discussed
in many cultures. Second, the rapid pace of change in medical technology has made it difficult to develop a standard
terminology for discussing dying and death. Third, dying and death are so rooted in cultural customs and individual

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beliefs and behaviors that a universal vocabulary has not evolved. The same words have different meanings to
different people. Fourth, issues of life and death are deeply personal, tapping our most basic human values.

These discussion are particularly difficult because of a lack of consensus about descriptive terminology. Different
words may be used by different writers for the same concept, or the same terminology may be used but with a variety
of meanings. Many terms are straightforward and utilized in a relatively uniform and systematic way in the literature.
Other terms are used selectively to frame arguments or positions. Roy and McDonald (1998) have noted that the
language used to describe decisions that shorten or do not prolong life can "signify opening moves in a moral debate"
(p. 123). Two commonly used terms that frequently generate confusion or controversy are "hastened death" and
"assisted suicide."

The Term "Hastened Death"

Some authorities believe that the psychosocial, cultural, medical, and ethical issues associated with all end-of-life
decisions affecting the time of death are similar. They use the term "hastened death" to refer to a variety of
interventions including voluntary cessation of eating and drinking, withholding and withdrawing life-sustaining
treatment, the double effect phenomenon, terminal sedation, assisted suicide, and voluntary (but not involuntary)
euthanasia (Cantor & Thomas, in press). Others limit the term to include only double effect, terminal sedation, and
assisted suicide (Alpers & Lo, 1999). Still others use the term to include only assisted suicide and euthanasia (Block &
Billings, 1998). Others do not use the term at all but prefer to describe the specific intervention under discussion.

Differences in the use of the term "hastened death" arise from disagreements about what types of interventions can
rightfully be likened to others. For example, some would argue that withdrawing life-sustaining treatment can be
placed on the same continuum as assisted suicide because they both speed up the dying process. Others would
argue that to place such terms under the single rubric of hastening death creates an unacceptable perception of
permissibility for certain interventions like assisted suicide that should never be allowed. In this view assisted suicide
is sharply distinguished from "letting the person die" from the underlying disease process by, for example, withholding
or withdrawing treatment. In general, differences in use of the term hastened death represent different views about
what types of interventions are permissible under what circumstances as well as different views about the potential for
abuse associated with different end-of-life interventions.

The Term "Assisted Suicide"

In the United States, the term "assisted suicide" commonly refers to situations in which people with incurable, and
ultimately terminal, illnesses, request the help of others in ending their lives. Assisted suicide has been defined by the
American Association of Suicidology (1996) as "the deliberate and knowing provision of information, the means,
and/or help to another person for an act of suicide" (p. 6). Those who reject the use of the word "suicide" in end-of-life
contexts focus on at least two major points. First, they argue that the use of the term may be an inappropriate
extension of the model of suicide (Sullivan & Youngner, 1994). According to this view, "the cutting short of a viable
life, as generally connoted by the term 'suicide', differs from a terminally ill patient's attempt to exercise some control
over their dying process" (Farrenkopf & Bryan, 1999, p. 245). They suggest that the traditional view of suicide as a
self-destructive act that is motivated primarily by emotional distress or psychopathology does not apply to all situations
in which a terminally ill person wants to exercise control over the timing and manner of death. A second argument of

153
those who do not like the term is that most of the suicidology literature is based on the contention that all people who
want to die have significant psychopathology and should be prevented from dying (Society for Health & Human
Values, 1995). Those who argue against the use of the term "assisted suicide" point to evidence that indicates that
some decisions to die are not motivated by clinical depression or other psychopathology (MacDonald, 1999). Third, in
general, those who view helping an incurable, terminally ill person to die as a legitimate issue to be considered along
with other end-of-life decisions believe that using the word "suicide" in the end-of-life context may negatively bias
discussion and decision-making. For example, The Oregon Death with Dignity Act (1995) states that "under the Act,
ending one's life in accordance with the law does not constitute suicide." The Act specifically prohibits euthanasia,
where a physician or other person directly administers a medication to end another's life.

Those who prefer the term "assisted suicide" in the context of end-of-life decision-making see the action as
qualitatively different from other medical decisions that may affect the time of death. First, they assert that the suicide
prevention model is applicable even at the end of life since there is evidence that terminally ill people who want to die
are clinically depressed (Chochinov et al., 1995, Canetto & Hollenshead, 1999). They hold that the term "assisted
suicide" carries implications for prevention and promotes caution in responding to requests. Second, they argue that
incurability and terminal status are hard to diagnose definitively. Third, they argue that requests for assisted suicide
can almost always be addressed by exploring and treating unmet needs of dying people (Emanuel, 1998). They point
out that there are higher costs associated with decisions leading to death because they are irreversible and subject to
abuse and to medical error. Fourth, some equate assisted suicide with killing. Therefore, they believe that using the
term assisted suicide or physician-assisted suicide is the most accurate descriptor that does not obscure, embellish,
or use euphemisms for what is happening.

Futility

Perhaps the most difficult decisions confronting people at the end of life are those about discontinuing life-extending
treatment. Frequently, in the course of caring for a critically ill person, it may become apparent that further intervention
will only prolong the dying process and not improve quality of life. Decisions to withhold or discontinue treatment are
determined by a variety of factors, including judgments of medical futility and the emotional status and coping styles of
the family members and the dying person. At that point, additional treatment is often described as futile. The concept
of medical futility takes shape in sociocultural and interpersonal contexts, and conflicts about whether a situation is
futile may arise for several reasons. Family members may disagree about future treatment or may oppose the
physician's recommendation to discontinue life support. The physician may want to continue treatment and be
opposed by either the family or other medical professionals. Legal or ethical issues may also play a role in the
decision to stop or maintain life supports. Issues of resource allocation can also influence judgments of futility and life-
extending care. Some argue that discontinuation of futile care is good for individuals, families, and society. Others
have countered that costs may be a primary motive behind assessments of futility, which disproportionately
discriminates against dying persons with limited resources.

Advance Care Directives

Because decisions concerning futility often involve people who lack the capacity to understand their medical situation
or communicate their wishes, there has been a movement to encourage everyone to create advance directives about
their medical care while they are still competent. The intention is that by getting a person's desires about end-of-care

154
in writing or by designating a health care proxy, the complexities of making decisions when the dying person's
judgment is impaired by the physical and emotional effects of the illness would be reduced. Examples of advance
care directives include descriptions of circumstances in which treatment should be received or refused, what
extraordinary measures (if any) should be taken to preserve life, and what kind of pain management is wanted. Some
of these decisions may impact the time of death but they generally call for widely accepted, legal components of end-
of-life care, such as withholding or withdrawing life-sustaining treatments.

It is important to note that advance directives are not without their problems or limitations. Some of the common
issues cited in the literature include:

• Few people prepare advance directives, in part because of a generalized reluctance to face death;
• Even if people do have them, their wishes may not be followed;
• The kind of planning for death which is required in advance directives goes against the values of many
cultural and religious communities, including the perceived duties of dying persons and their families;
• Individual preferences for life-sustaining medical treatments are only moderately stable within the short term
(up to six months) and are even less stable over longer periods;
• Healthy individuals appear to be unable to predict their own preferences under states of impaired health;
• Substantial fluctuations in the will to live have been documented in terminally ill people in palliative care
settings;
• Among the factors that appear to play a role in the refusal of life-sustaining treatments are depression and
family support;
• Concerns about costs influence the preferences of individuals and family members about life-extending
measures.

Health care providers must be sensitive to the limitations of an advance directive for a particular individual over time,
the need for ongoing exploration of the desires and needs of dying people and their loved ones, and the likelihood that
such directives may be in conflict with some people's values and traditions.

References

Alpers, A., & Lo, B. (1999). The Supreme Court addresses physician-assisted suicide. Archives of Family Medicine, 8,
200-205.

American Association of Suicidology. (1996). Report of the Committee on Physician-Assisted Suicide and Euthanasia.
Suicide and Life-Threatening Behavior, 26(Suppl.), 1-19.

Block, S. D., & Billings, J. A. (1998). Evaluating patient requests for euthanasia and assisted suicide in terminal
illness: The role of the psychiatrist. In M. D. Steinberg, S. J. Youngner (Eds.), End of life decisions: A psychosocial
perspective (pp. 205-233). Washington, DC: American Psychiatric Press.

Canetto, S. S., & Hollenshead, J. (1999). Gender and physician-assisted suicide: An analysis of the Kevorkian cases,
1990-1997. Omega, 40, 165-208.

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Cantor, N. L., & Thomas, G. C., III. (in press). The legal bounds of physician conduct hastening death. Buffalo Law
Review.

Chochinov, H. M., Wilson, K.G., Enns, M., Mowchun, N., Lander, S., Levitt, M., & Clinch, J. (1995). Desire for death in
the terminally ill. American Journal of Psychiatry, 152, 1185-1191.

Emanuel, L. L. (1998). Facing requests for physician-assisted suicide: Toward a practical and principled clinical skill
set. JAMA, 280, 643-647.

Farrenkopf, T. & Bryan, J. (1999). Psychological consultation under Oregon's 1994 Death With Dignity Act: Ethics and
procedures. Professional Psychology: Research and Practice, 30, 245-249.

MacDonald, R. (1999). Physician-assisted rational suicide. In J. L. Werth, Jr. (Ed.), Contemporary perspectives on
rational suicide (pp. 107-113). Philadelphia: Taylor & Francis.

Oregon Death with Dignity Act (1995). Or. Rev. Stat. ßß 127.800 - 127.995.

Roy, D. J. & MacDonald, N. (1998). Ethical issues in palliative care. In D. Doyle, G. W. C. Hanks, & N. MacDonald
(Eds.), Oxford Textbook of Palliative Medicine (2nd ed.) (pp. 97-138). Oxford: Oxford University Press.

Society for Health and Human Values Task Force on Physician-Assisted Suicide (1995). Physician-assisted suicide:
Toward a comprehensive understanding. Academic Medicine, 70, 583-590.

Sullivan, M. D., & Youngner, S. J. (1994). Depression, competence, and the right to refuse lifesaving medical
treatment. American Journal of Psychiatry, 151, 971-978.

Assisted Suicide

Arguments supporting or opposing assisted suicide are generally made from several frames of reference. These
include ethical and moral arguments, legal arguments, medical arguments, and arguments regarding safeguards and
the slippery slope.

Arguments in Support of Assisted Suicide

Ethical and moral arguments include the principle of self-determination to control the time, place, and nature of one's
death, placing quality at the end of life above the sanctity of life. Other factors include the desire to preserve dignity
and personhood in the dying process and opposition to prolonging life by using sophisticated medical technology
when it is recognized that care is futile. Closely related to self-determination is the principle of autonomy. This
principle states that persons should have the right to make their own decisions about the course of their own lives
whenever they can. By extension, they should also have the right to determine the course of their own dying as much
as possible.

According to these arguments, even when choices are socially shaped they should be respected as autonomous as
long as there is appropriate evaluation of decisional capacity. No person should have to endure terminal suffering that

156
is unremitting, unbearable, or prolonged. When the burdens of life outweigh the benefits because of uncontrollable
pain, severe psychological suffering, loss of dignity, or loss of quality of life as judged by the patient, and when the
circumstances are not remediable, the dying person should be able to ask for and receive help in assisted suicide. It
is further argued that assisted suicide for incurably ill persons experiencing extreme suffering can be distinguished
from euthanasia used for the purpose of genocide on the grounds that it is based on principles of dignity, honor, and
respect and is chosen and enacted by the dying individuals, rather than being forced on them against their will.

Legal arguments state that it would be in the best interest of dying patients to be able to regulate practices that are
currently being used covertly for assisted suicide. Such regulations would also provide safeguards for practitioners
who are currently complying illegally with patient requests out of compassion.

Medical arguments contend that competent terminally ill patients wishing to choose assisted suicide may feel
abandoned by physicians who refuse to assist. The criticism that medical doctors agreeing to assist in suicide would
be violating the Hippocratic Oath is refuted on several grounds. First, the original Oath prohibiting killing also
prohibited abortions, surgery, and charging teaching fees, all of which have been modified to meet contemporary
realities. Second, assisted suicide, unlike euthanasia, does not involve the ending of life by a physician, as it is the
dying person himself or herself who takes the steps to end his or her life. Third, the Oath requires physicians to take
all measures necessary to relieve suffering, and some interpret this to include assisted suicide when that is the only
way suffering can be relieved.

The argument regarding safeguards and the slippery slope holds that it is possible to protect people from abuse
through appropriate regulation which would provide oversight by a combination of state legislation and professional
regulation by palliative care consultants and ethics committees that would include professionals and community
representatives. Several models for safeguards have been proposed and typically include confirmation of diagnosis,
prognosis, treatment options, and decision-making capacity; assessment for alternative means of alleviating suffering;
nondirective counseling; education of physicians; and education of the public.

It is further argued that widely utilized and commonly accepted legal end-of-life interventions such as withholding or
withdrawing treatment, double effect, and terminal sedation are also subject to the slippery slope or to abuse and yet
are considered to be controllable by standards of care and appropriate regulation and oversight. Likewise, financial
concerns may be a factor in requests for legal interventions as well as in requests for assisted suicide and yet are not
considered as a justification for prohibiting these other interventions.

The safeguards argument posits that involving mental health professionals to provide appropriate and comprehensive
treatment planning would improve quality of care and reduce the potential for abuse regarding all end-of-life
interventions that may affect the time of death. Regarding the issue of depression which, if treated, could change a
terminally ill person's request for assisted suicide, it is pointed out that first, treatment of depression does not always
change the desire for assisted suicide, and second, psychologists can play a major role in assessment and treatment
of depression and other psychological factors that may affect judgment and requests for a variety interventions that
affect the time of death including but not limited to assisted suicide.

Arguments in Opposition to Assisted Suicide

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Ethical and moral arguments begin with the principle of protection of the socially and economically disadvantaged.
Concerns are raised that persons whose autonomy and well-being are compromised by poverty or by membership in
a stigmatized social group, (such as women, persons with disabilities, ethnic, sexual, and other minorities, and ill older
persons in general) will be coerced into assisted suicide. The pressure to choose suicide may not be explicit and
personal, because persons who experience stigma may internalize a diminished sense of entitlement to resources,
and may be the ones who most strongly argue for their own demise. The principle of individual choice in dying is
viewed as a fiction in a highly stratified society, such as the United States, where access to basic health care is highly
variable and dependent upon personal income and private insurance. Many seriously ill persons may not have the
resources necessary for implementation of the choice to live.

From within this perspective, the individual paradigm of decision-making, with its emphasis on independence and
choice, is seen as obscuring the reality that decisions about care at the end of life are typically made by physicians
with some consultation with family members and with cost containment being an important factor in these decisions.
Another ethical argument opposing assisted suicide comes from the principle of respect for human life and the related
beliefs that killing is wrong, even if a person consents to it. Some, who see assisted suicide as similar to euthanasia,
believe that moral objections to assisted suicide are strengthened by examining historical precedents, specifically the
experience of Nazi Germany in which "undesirable" groups of people (including Jews, persons with disabilities, and
sexual minorities) were put to death.

Legal arguments against assisted suicide include concerns about civil suits resulting from premature or unnecessary
termination of life following a diagnostic error or incorrect prognosis. There are also concerns about enforcement of
legal procedures devised to prevent against misuse, abuse, and improper application or coercion in assisted suicide.

Medical arguments against assisted suicide include the possibility of misdiagnosis, the potential availability of new
treatments, and the probability of incorrect prognosis. Because medicine is fallible and research is ongoing, incorrect
diagnoses may result in unnecessary requests for assisted suicide or in requests that are carried out just before the
introduction of a new treatment that could prolong life. Another medical argument is that requests for assisted suicide
may indicate that improved palliative care, aggressive pain management, and better psychosocial support are
needed. Further, there is serious concern that the availability of assisted suicide may create a disincentive to providing
appropriate but costly medical treatments or to improving the quality and availability of palliative and hospice care.

In addition, the American Medical Association has asserted that physician-assisted suicide is fundamentally
incompatible with the physician's role as healer and that it poses serious societal risks, such as ill persons' feeling
abandoned or losing trust in the health care system if providers participate in this practice. Finally, it is argued that
physicians are barred from helping persons to die because of the Hippocratic Oath, which states that doctors should
not kill.

The argument against assisted suicide regarding safeguards and the slippery slope maintains that once assisted
suicide is accepted as an available option for competent terminally ill adults, it may be permitted for ever-larger groups
of persons, including the nonterminally ill, those whose quality of life is perceived to be diminished by a physical
disability, persons whose pain is emotional instead of physical, and so forth. Critics point to the fact that permitting
euthanasia and assisted suicide, as is done in the Netherlands, does not prevent violation of procedures (e.g., failure
to report) or abuse (e.g., involuntary euthanasia).

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It is further contended that adequate safeguards are not possible. For example, requiring written requests to be
repeated over a period of time and witnessed by two unrelated witnesses while at the same time involving at least two
physicians and a psychiatrist's or psychologist's examination is unrealistic. Persons at the end of their lives typically
have neither the energy nor the ability to meet such conditions. A related argument is that the option of assisted
suicide for mentally competent, terminally ill people could give rise to a new cultural norm of an obligation to speed up
the dying process and subtly influence end-of-life decisions of all sorts.

What Experience Teaches: Oregon and the Netherlands

The Oregon Experience

When controversy surrounds an issue, psychologists have been trained to turn to research and data for
enlightenment. However, in the area of assisted suicide, which only recently has been explicitly legalized in the United
States in the state of Oregon, there is an understandable dearth of research. Nevertheless, the experience with
assisted suicide in Oregon is relevant to the recommendations in this report. It is, therefore, worth exploring in some
depth.

The Oregon Death with Dignity Act states the following:

An adult who is capable, is a resident of Oregon, and has been determined by the attending physician and consulting
physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make
a written request for medication for the purpose of ending his or her life in a humane and dignified manner in
accordance with ORS 127.800 to 127.897. (Task Force to Improve the Care of Terminally Ill Oregonians, 1998, p. 57)

Other sections of the law are designed to provide safeguards for the practice. For example, the written request must
be witnessed by two unrelated persons; there must be a consulting physician; the patient must make an informed
decision; the attending or consulting physician can request a referral to a licensed psychologist or psychiatrist if they
suspect that a psychiatric condition or depression may be causing impaired decision- making; and family notification is
recommended.

A study of Oregon's first year of legalized assisted suicide analyzed data for all terminally ill Oregon residents who
received prescriptions for lethal medications (Chin et al., 1999; see also Coombs Lee & Werth, in press). A total of 23
persons receiving prescriptions were reported to the Oregon Health Division; 15 died after taking the medications, six
died from the underlying illnesses, and two were still alive as of January 1, 1999. The 15 assisted suicides accounted
for five out of every 10,000 deaths in Oregon in 1998. Eight of the 15 were male and seven were female, and all were
of European American descent. Only four of the candidates had psychological or psychiatric consultations.

The researchers reported that the primary factor cited by the physicians of those who requested assisted suicide was
the importance of autonomy and personal control. No person who chose assisted suicide had expressed financial
concerns to their doctors, nor was pain associated with the illness cited as a major factor. The researchers concluded
that requests for and use of lethal prescriptions to end life were associated with views on autonomy and control rather
than fear of pain or economic concerns. The only statistically significant differences between those who died by lethal
medication and matched controls were that the former were more likely to be divorced or never married and they were
higher in physical functioning.
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Advocates for and opponents of assisted suicide have different reactions to these findings. Advocates view these
results as evidence that independence and autonomy are strong personal values for persons seeking assisted
suicide. Opponents argue that if those persons had better psychosocial support and close caregivers they may not
have chosen to die at that time. Advocates also interpreted the difference in physical functioning to demonstrate
values of independence and control. Opponents expressed concerns about the influence of internalized negative
views concerning physical disabilities and suggested that with more time to adjust to disabilities, as well as better
services and less social stigma, these individuals might have chosen to live longer.

There has been criticism of the study and its conclusions on methodological grounds (Foley & Hendin, 1999). All
information about the cases was provided by the physicians; thus, there are no data in the study from the individuals
who died of assisted suicide or their family members, so there are only anecdotal discussions (e.g., Coombs, Lee, &
Werth, in press; Reagan, 1999) of the psychological motivations of the person requesting assisted suicide and the
interpersonal cultural context in which the decision to use the Death with Dignity Act developed. Information about the
health of patients is limited to diagnosis and prognosis and no data are available regarding the basis on which the
physicians made the diagnoses and prognoses. There is no independent way to ascertain how adequately physicians
addressed palliative and hospice care options, how thoroughly they assessed the reasons for requests for assisted
suicide, or whether they were fully informed about the economic and social circumstances of patients. The report also
does not indicate the basis on which physicians referred the four patients for psychiatric or psychological evaluation
and what, if any, assessments were conducted following referral.

The report of the second year of the Oregon Death with Dignity Act was released in late February, 2000 (Sullivan et
al., 2000a, b). The document updated the 1998 data and provided information for 1999. The analyses for the second
year report included 26 people who received prescriptions and used them in 1999 as well as one person who received
the medication in 1998 but did not use it until 1999. The median age of these 27 people was 71, 16 were male, 26
were European Americans, and 17 had cancer. All of them had health insurance and 21 were enrolled in hospice prior
to death. One person became unconscious before consuming all the prescribed medication and, as a result, took 26
hours to die. Two others took more than 11 hours to die. The relatively long period from when the medication was
taken to when death occurred would have been considered a "clinical problem" in the Netherlands (Groenewoud et
al., 2000); however, variations in the length of time from ingestion to death are expected (Schnabel & Schnabel,
1998).

The 27 people who died were demographically similar to the people who used the Act in 1998, except they were
significantly more likely to be married. These individuals were demographically similar to other Oregonians who died
of similar diseases except they were significantly more likely to be college educated. Ten of the 27 people who used
the Act had been referred for a mental health evaluation. These 27 people accounted for nine out of every 10,000
deaths in Oregon in 1998.

Similar to 1998, the most frequent concerns recorded by physicians about those who died of assisted suicide were
loss of autonomy and decreasing ability to participate in activities that made life enjoyable. The 1999 report also
contained the results of interviews with family members of 19 people who died between mid-September, 1998 and
mid-October, 1999. These significant others cited individual concerns about losing autonomy, losing control of bodily
functions, and physical suffering. Nearly 75% of the family members also volunteered that the dying person wanted to
control the time and manner of death.

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Another research study related to the Oregon Death with Dignity Act was released at the same time as the second
year report. This article examined physicians' experiences with the Act (Ganzini et al., 2000). The researchers
reported that their survey of all eligible Oregon physicians revealed that 144 of the respondents (65% response rate)
had received 221 requests for assisted suicide under the Act. Twenty-nine of these individuals received medication
and 17 used the prescription to die. Twenty percent had symptoms of depression and none of these received a
prescription. Physicians implemented substantive palliative care interventions for 68 patients, 10 of whom eventually
used the prescribed medication; 46% of those who received an intervention changed their minds about using the
Death with Dignity Act, whereas only 15% of those who did not receive a substantive intervention decided against
assisted suicide.

The data contained in the second year report (Sullivan et al., 2000a, b) and in the Oregon physician experience study
(Ganzini et al., 2000) are too new to have been broadly examined by proponents and opponents of the Oregon law
(see Nuland, 2000). However, just as the data from 1998 were used by both sides of the debate to bolster their
arguments, the same process is bound to happen with the new reports.

The Netherlands Experience

A second example of differential interpretation of data concerning assisted suicide is apparent in the research
published on assisted suicide and euthanasia in the Netherlands. Before discussing the data, it must first be noted
that the policy and practice of assisted suicide, and the context of such practice in the Netherlands, are different from
those of assisted suicide in the United States (Griffiths, Bood, & Weyers, 1998). Unlike the United States, both
assisted suicide and euthanasia are decriminalized and permissible in the Netherlands under prescribed
circumstances. Also, in the Netherlands, there is universal health coverage; the population is more homogeneous,
with a smaller range of cultural diversity; and family doctors have typically known their patients for long periods of
time. Thus, it is difficult to generalize from Dutch policy and practice to the situation in the United States. However,
with these differences in mind, it is useful to examine the data from the Netherlands.

A 1991 article summarized the findings of a nationwide study of physicians reporting on their practice of assisted
suicide and euthanasia in the Netherlands (van der Maas, van Delden, Pijnenborg, & Looman, 1991). This report
indicated that out of the roughly 130,000 deaths that occurred in the Netherlands in 1990, 2300 (1.8%) were the result
of euthanasia. Another 400 (0.3%) were assisted suicides. The report found that in the 2700 cases reviewed, the
medical guidelines were met. This means that the patients were mentally competent adults who were suffering without
alternatives and who requested assisted suicide or euthanasia voluntarily, consistently, and repeatedly over a
reasonable time. The requests were documented. According to the reporting physicians, the patients were suffering
intolerably with no prospect of relief and the primary doctors consulted with another physician not involved in the case.
However, the report also noted that there were an additional 1,000 deaths (0.8%) caused by euthanasia in which the
patient was not concurrently competent, a clear violation of the guidelines. About a quarter of the physicians admitted
causing death without an explicit request.

Opponents of assisted suicide in the United States point out that data that is based on physician's reports is
unreliable. They also argued that the deaths of the 1000 people who were not concurrently competent was evidence
that the slippery slope is occurring. They suggested that further erosion of the guidelines could occur, resulting in

161
involuntary euthanasia being performed on older adults, persons with disabilities, and adults who were not mentally
competent (Gomez, 1991; see also Angell, 1996).

Proponents of assisted suicide, referring to the same data, pointed out that the results showed a very cautious use of
euthanasia and assisted suicide, accounting for only a small fraction of the total deaths. Moreover, only one in three
people who requested assisted suicide and euthanasia were granted it, which did not indicate any great trend on the
part of physicians to accede to such requests. With regard to the 1,000 persons who died from euthanasia without any
consent, interviews with the attending doctors indicated that over half had earlier stated a desire for euthanasia and
that most were "moribund" at the time euthanasia was performed, so that these were cases of euthanasia without
concurrent consent (i.e., nonvoluntary) rather than euthanasia without any consent (i.e., involuntary).

A follow-up study, completed in 1995, focused on two issues. The first was whether a slippery slope existed with
regard to medical care at the end of life (van der Maas et al., 1996). The second concerned the efficacy of a new
notification procedure designed to enable better monitoring of euthanasia and assisted suicide that became law in
1994 (van der Wal et al., 1996). The authors of the first report concluded that there was little evidence of a slippery
slope occurring. Dutch doctors seemed to "continue to practice physician-assisted dying only reluctantly and under
compelling circumstances" (Angell, 1996, p. 1677). The notification procedures, however, had only partial success.
The numbers of reported physician-assisted deaths increased but doctors found the procedures unduly difficult and
were still concerned about the legal status of admitting to euthanasia.

Critics of assisted suicide in the U.S. have challenged the findings of the second study. They disagreed with the
conclusion that there is no evidence that "physicians in the Netherlands are moving down a slippery slope" (Hendin,
Rutenfrans, & Zylicz, 1997, p.1720). They pointed out that

in the past two decades, the Netherlands has moved from considering assisted suicide . . . to giving legal sanction to
both physician-assisted suicide and euthanasia; from euthanasia for terminally ill patients to euthanasia for those who
are chronically ill; from euthanasia for physical illness to euthanasia for psychological distress; and, from voluntary
euthanasia to nonvoluntary and involuntary euthanasia. (p. 1720)

These opponents of assisted suicide also reanalyzed the data and showed an increase over time in the estimated
number and percentage of deaths caused by active physician intervention.

Thus, the results of the same study have been interpreted in widely different ways depending on the point of view of
those studying the data. As was the case with the Oregon data, the meaning and implications of the Netherlands data
have varied.

Other Related Studies

In addition to research conducted where assisted suicide is legal or decriminalized (e.g., Oregon and the
Netherlands), there have been other studies conducted where the practice continues to be illegal. Predictably, only a
few involved terminally ill people who actually died as a result of assisted suicide. These studies (Back et al.,1996;
Canetto & Hollenshead, 1999; Preston & Mero, 1996) indicate that pain plays a minor role in the reasons why people
die by assisted suicide; factors such as concerns about loss of control, perceived loss of dignity or sense of self, and
suffering other than physical pain appear to be crucial issues (Wilson, Viola, Scott, & Chater, 1998).
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Some investigations on end-of-life decisions have included people who are terminally ill (Breitbart, Rosenfeld, &
Passik, 1996; Brown, Henteleff, Barakat, & Rowe, 1986; Chochinov, Wilson, Enns, & Lander, 1998; Chochinov et al.,
1995; Ganzini et al., 1998; Rabkin, Remien, Katoff, & Williams, 1993; Suarez-Almazor, Belzile, & Bruera, 1997;
Wilson et al., in press). The results of several of these studies reveal that high levels of clinical depression and
hopelessness, low perceived levels of social support, the perception that suffering is inevitable, and the perception of
being a burden are associated with increased interest in assisted suicide or a desire to die. Similarly, some studies of
chronically, but not necessarily terminally, ill individuals (e.g., Emanuel, Fairclough, Daniels, & Clarridge, 1996) have
found that depression is an important influence on the desire for assisted suicide whereas others (e.g., Sullivan,
Rapp, Fitzgibbon, & Chapman, 1997) have found that symptom level is more important than the degree of depression
in determining the acceptability of assisted suicide. Furthermore, some research has revealed that concerns about
costs (together with age and depression) can influence a person's decision to give up on life-extending measures
(e.g., Covinsky et al., 1996). A retrospective study of Dr. Kevorkian's cases also showed that general psychological
distress and concerns about being a burden were common among the women who died with his assistance (Canetto
& Hollenshead, 1999).

There have been a few investigations of the impact of assisted suicide on significant others (Cooke, et al., 1998;
Jamison, 1995; Ogden, 1994). This research indicates that loved ones of people who have died by assisted suicide
are not necessarily traumatized by their awareness of or involvement in the actions that lead to death. Rather, it
appears as though concern about legal repercussions can lead to significant anxiety, and that trauma can occur if
loved ones felt obligated to take an active role in the death in unanticipated ways because the planned method was
unsuccessful.

Research involving health care professionals is also relevant to this discussion (the Resource Guide will contain a
review of surveys of attitudes of health care providers about assisted suicide). For example, some evidence suggests
that physicians tend to under-recognize depression (Conwell & Caine, 1991; Peruzzi, Canapary, & Bongar, 1996). In
addition, primary care physicians underestimate older persons' preferences for life-extending care while hospital-
based physicians (emergency and critical care physicians), like family surrogates, overestimate older persons'
preferences for life-extending care (Coppola, Ditto, Danks, & Smucker, in press). In addition, there are data indicating
that physicians' training and experience with serious medical illness affects their perception of the desirability of
different options. Specifically, clinicians with the least exposure to seriously ill and dying patients are more willing to
endorse assisted suicide and/or euthanasia than oncologists; this is also true for social workers, compared to nurses
(Bachman et al., 1996; Portenoy et al., 1997). Other factors that contribute to greater willingness to support assisted
suicide are a limited knowledge of pain management (Portenoy et al., 1997) and a conservative attitude toward
resource use (Sulmasy, Linas, Gold, & Schulman, 1998).

Finally, there is evidence to suggest that the majority of those willing to serve as consultants to evaluate a person's
competence for assisted suicide favor the practice (Fenn & Ganzini, 1999; Ganzini, Fenn, Lee, Heintz, & Bloom,
1996). This may be the result of the fact that many health professionals who are opposed report that they would
refuse to participate in the process. Bias in the mental competence evaluation may result, because those who support
assisted suicide as an option may be more willing to find a dying person's judgment to be unimpaired while opponents
indicate that even if they found the person's judgment to be unimpaired, they would attempt to prevent the person
from receiving assisted suicide.

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Summary

Reasonable and well-informed people come to different conclusions on the meanings and implications of the data
concerning assisted suicide. These positions grow out of different philosophies, value systems, and life experiences,
and each can represent high levels of moral development. Individuals may strongly oppose or support assisted
suicide, believing that it is the appropriate position of compassionate and socially responsible citizens. Both
proponents and opponents of assisted suicide agree that there are costs and benefits to permitting versus banning
the practice. However, they differ in their assessment of these relative costs and benefits. Furthermore, the current
state of understanding of all of the issues surrounding assisted suicide is incomplete. The data that do exist are far
from definitive and the lack of consensus on the interpretation of these data contribute to the differences in opinion
about assisted suicide. Finally, there currently is no way of identifying the sequelae of legalizing assisted suicide in the
United States, which remains a diverse culture with unequal access to medical care. Given the current state of the
discourse on assisted suicide, it seems premature for the discipline of psychology to take a stand supporting or
opposing assisted suicide.

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Glossary of Terms

Advance care directives (or simply advance directives) are written documents meant to make explicit the conditions
under which individuals expect to wish to receive certain treatment or to refuse or discontinue life-sustaining
treatment, in the event that they are no longer legally competent to make their own decisions.

A durable power of attorney (sometimes referred to as a health-care proxy) is a form of advance directive that
designates an individual who can make decisions if the dying person is no longer competent to do so.

A living will is a form of advance directive that specifies in writing what kinds of treatment are and are not wanted.

Aggressive pain management is an essential component of palliative care intended to provide relief from physical
suffering at the end of life.

The double effect is a term given to the practice of providing large doses of medication to relieve pain even if the
unintended effect of such medication may be to hasten death.

Terminal sedation is the term given to the practice of administering sufficient pain medication to render a dying
person who is suffering severe, intractable pain unconscious (i.e. to induce an artificial coma). Generally, artificial
nutrition and hydration are also withheld or withdrawn, and the state of unconsciousness is maintained until death
occurs.

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Assisted suicide refers to the situation in which persons request the help of others, in the form of access to
information or means, the means, and/or actual assistance, in order to end their own lives.

Physician-assisted suicide refers to cases in which a physician deliberately and knowingly helps an individual to die
(American Association of Suicidology, 1996).

Euthanasia generally refers to situations whereby someone intentionally takes a person's life with stated intent to
alleviate or prevent perceived suffering (American Association of Suicidology, 1996).

Active euthanasia is the practice of shortening an individual's life by taking a lethal action such as administering a
lethal dose of medication with the intent to hasten death. It is illegal in the United States.

Passive euthanasia is an older name given to withholding or withdrawing life-sustaining treatment that could
otherwise prolong life. The term is no longer in wide use in the United States.

Voluntary euthanasia occurs when a competent dying individual has given voluntary, informed consent to actions
that will result in death.

Nonvoluntary euthanasia occurs when a person, who is not currently capable of giving consent to actions that will
result in death, receives such actions. It applies to situations when death by euthanasia is believed to be consistent
with the person's prior wishes.

Involuntary euthanasia occurs in situations in which the euthanasia is carried out without consent or against the will
of the recipient. Active euthanasia of all kinds is illegal in the United States, and all involuntary euthanasia, whether
passive or active, could lead to charges of homicide.

Hastened death is an inconsistently defined term meaning to end one's life earlier than would have happened without
intervention. Some use it to refer to assisted suicide and euthanasia only. Others, however, include in this category
withholding and withdrawing treatment, death caused by aggressive pain management, and voluntary cessation of
eating and drinking.

Hospice refers to programs that focus on quality of life for dying persons. The first modern hospice, St. Christopher's
Hospice in London, was founded by Dr. Cicely Saunders in 1967. The defining components of the hospice approach
are as follows (Lattanzi-Licht & Connor, 1995, p. 145):

• The patients and family are the unit of care.

• A comprehensive, holistic approach is taken to meet the patient's physical, emotional, social, and spiritual
needs, including major attention to effective symptom control and pain management.
• Care is provided by an interdisciplinary team, which includes medical supervision and use of volunteers.
• The patient is kept at home or in an inpatient setting with a homelike environment where there is coordination
and continuity of care.
• In addition to regularly scheduled home care visits, services are available on a 24-hour, 7 day-a-week, on-
call basis.
• The focus of care is on improving the quality of remaining life; that is, on palliative, not curative, measures.
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 • Bereavement follow-up services are offered to family members in the year after the death of their loved one.

Palliative care refers to the type of care an individual may receive at the end of life after it becomes obvious that no
cure is possible. The World Health Organization (1990) stated that good palliative care:

• Affirms life and views dying as a normal process;

• Neither hastens nor postpones death;
• Provides relief from pain and other distressing symptoms;
• Integrates the psychological and spiritual aspects of patient care;
• Offers a support system to help patients live as actively as possible until death;Offers a support system to
help family members cope during a patient's illness and during their own bereavement.

The Patient Self-Determination Act (Omnibus Budget Reconciliation Act, 1990) is a bill passed by Congress that
requires all hospitals, HMO's, hospice, and extended care nursing homes participating in Medicare or Medicaid to ask
all adult inpatients if they have advance directives, to document their answers, and to provide information on related
state laws and hospital policies.

Withholding or withdrawing life-sustaining treatment is an ethically and legally accepted practice that may be
specified in advance care directives. It permits patients to forego or terminate life-sustaining equipment such as
ventilators, dialysis machines, feeding tubes for artificial nutrition and intravenous fluids for hydration, and the
sophisticated technology of the intensive care unit. In addition, it allows for aggressive treatments to be foregone or
terminated (e.g. chemotherapy or radiation therapy except for comfort care, antibiotics, certain anti-seizure
medications, or anti-inflammatory agents that control brain swelling).

The Do Not Resuscitate request is a form of withholding life-sustaining treatment that requires that no attempt be
made to revive a person who has died.

Voluntary cessation of eating and drinking, sometimes referred to as voluntary stopping of eating and drinking, is a
form of withholding or withdrawing life-sustaining treatment. Some individuals near the end of life who wish to die
several days to a few weeks sooner than would happen naturally may choose it. During this time palliative care may
be provided to keep the person comfortable during the time it takes for death to occur from the underlying disease
(Miller & Meier, 1998).

References

American Association of Suicidology. (1996). Report of the Committee on Physician-Assisted Suicide and Euthanasia.
Suicide and Life-Threatening Behavior, 26(Suppl.), 1-19.

Lattanzi-Licht, M., & Connor, S. (1995). Care of the Dying: The Hospice Approach. In H. Wass and R.A. Neimeyer
(Eds.), Dying: Facing the Facts. Washington, D.C.: Taylor and Francis.

Miller, F. G., & Meier, D. E. (1998). Voluntary death: A comparison of terminal dehydration and physician-assisted
suicide. Annals of Internal Medicine, 128, 559-562.

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Omnibus Budget Reconciliation Act. (1990). Public Law No. 101-508, ßß 4206, 4751 (codified in 42 U.S.C., 1395cc(f)
[Medicare] and 1396a(w) [Medicaid]).

World Health Organization (1990). Cancer Pain Relief and Palliative Care. Technical Report Series 804. Geneva:
Author.

გამოყენებული წყარო:
1.გოგიჩაიშვილი, განვითარების ფსიქოლოგია,თბილისი.თბილისი 2005
2.გრეის კრაიგი; დონ ბოკუმ "განვითარების ფსიქოლოგია" გამ. "პიტერი", სანქტ-
პეტერბურგი, 2008 (რუსულ ენაზე)
3.უზნაძე დ. „ბავშვის ფსიქოლოგია“.თბ.2003

4..ჰამილტონი ი. ს. ხანდაზმულების ფსიქოლოგია, მე-4 გამოცემა, გამომ. “პიტერ“, სანკტ-

პეტერბურგი, 2010 (რუსულ ენაზე).

ინტერნეტ რესურსები:

1.www.apa.org

2.www.oxfordscholarship.com

3.https://www.oxfordhandbooks.com/search?f_0=keyword&q_0=ageing

4.https://www.oxfordhandbooks.com/search?f_0=keyword&q_0=gerontology

saswavlo kursis xelmZRvaneli:

lana sulxaniSvili
fsiqologis doqtori,asocirebuli profesori

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