life review essay

17.4 Life Review, Successful Life, and a Good Death

Learning objectives.

By the end of this section, you will be able to:

• Explain the process and purpose of life review
• Identify factors that contribute to life satisfaction
• Identify factors that predict a good death

Sondra is seventy-five years young. She’s in good health and enjoys traveling, taking long walks, and spending time with neighbors and members of her synagogue. She lost her partner five years ago to heart disease and misses him terribly, but her faith and social supports provide comfort. She’s optimistic about the future and wants to make the most of each day. She often thinks about sayings she has heard: “The unexamined life is not worth living,” and “In the end, we regret only the chances we didn’t take.”

Statements like these contain a common theme—that life is something to be studied, perhaps with the idea of coming to some kind of conclusion or even making changes if we don’t like what we discover. Sondra is engaging in a life review and considering factors that describe a “good” life and what that means. She may also come to explore the notion of a “good death.”

Life Review

A life review is exactly what it sounds like—a thoughtful examination of our own life. You learned about one aspect of this topic in Chapter 16 Social and Emotional Development in Late Adulthood (Age 60 and Beyond) , in relation to Erikson’s ego integrity versus despair task. Erikson viewed this end-of-life evaluation as important for overall psychological well-being, even if its outcome exposed regrets. When we discover regrets, we can try to resolve them and take the end of our life in a more fulfilling direction.

For some people, a life review includes engaging in legacy activities , such as creating an artifact that represents their life and for which they want to be remembered. Examples include a photo album, scrapbook, cookbook, or letters written to loved ones. Participating in life review and legacy activities is associated with improvements in emotional distress, death preparedness, and perceived quality of life (Allen, 2009; Allen et al., 2014; Grewe, 2017; Ingersoll-Dayton et al., 2019; Keall et al., 2015; Pinquart & Forstmeier, 2012; Shin et al., 2023). When family members participate too, they report benefits such as an increased sense of meaning (Allen et al., 2014) and improved communication (Allen, 2009).

Similar to life review is reminiscence , the act of recalling and sharing memories and stories, typically pleasant ones. We often do this on an informal or short-term basis and to enhance social connections, happiness, and self-esteem (Keall et al., 2015; Shin et al., 2023), although it can also be a therapeutic activity. Studies of reminiscence therapy find it can bring improvements in perceived quality of life, emotional well-being, and contentment, as well as affirmation of relationships, particularly if couples participate together, and decreased anxiety about death (Ingersoll-Dayton et al., 2019; Pinquart & Forstmeier, 2012; Shin et al., 2023).

Link to Learning

It can be a pleasant experience to do reminiscence or life review activities with others, regardless of age.

• Learn more about different reminiscence therapy activities and games , such as the “Grab Bag” storytelling game and “Calendar Flashback.”
• Read about reminiscence therapy activities specifically for people with dementia.
• Explore suggestions for creating a legacy through legacy activities , such as journaling and letter-writing.
• Legacy activities can also be done collaboratively with others; find more ideas for group legacy activities that can be done with people of any age.

A Successful Life

How do we define a successful life? First, we must distinguish a successful life from life satisfaction and ego integrity. Someone experiencing life satisfaction is content with their current circumstances. Someone who feels they’ve had a successful life looks positively at their past as a whole. That doesn’t mean their life has been without disappointments and setbacks. Rather, given a realistic appraisal of both positive and negative events, the person integrates these into a whole that reflects feelings of competency (Filip et al., 2020; Haber, 2006; van der Kaap-Deeder et al., 2021; Van Hiel & Vansteenkiste, 2009). They may also come to terms with and learn from negative experiences or release regrets (Haber, 2006).

What makes a successful life is highly individual, since any two people are likely to define it differently ( Figure 17.19 ). However, research has identified some common themes and elements associated with feelings of success. Some studies asked people open-ended questions about whether they felt their lives had been successful. Other research used structured inventories such as the Meaning in Life Questionnaire, which asks respondents to rate on a 7-point scale statements like “My life has a clear sense of purpose” and “I am always looking for something that makes my life feel meaningful” (Steger et al., 2006).

Self-determination theory (Deci & Ryan, 2000) provides a framework for identifying some components of a successful life by emphasizing the value of intrinsic goals over extrinsic goals. Intrinsic goals such as autonomy and competence are believed to contribute more to lifelong personal growth (Deci & Ryan, 2000; Van Hiel & Vansteenkiste, 2009) and therefore are more relevant for defining a successful life. According to self-determination theory , these goals are characterized by autonomy or the freedom to make our own choices, competence or our achievement of personal goals, and relatedness or our feeling of being connected to others (Deci & Ryan, 2000; van der Kaap-Deeder et al., 2021; Van Hiel & Vansteenkiste, 2009). Let’s look at these a little more closely.

Autonomy and Competence

The themes of autonomy and competence come up in Erikson’s psychosocial stages and Bandura’s concept of self-efficacy. In self-determination theory, however, autonomy primarily refers to the freedom to make our own choices, not necessarily the ability to perform tasks without assistance. Both autonomy and competence appear to be associated with achieving ego integrity (Filip et al., 2020) and better mental and physical well-being (Chen et al., 2015; Van Hiel & Vansteenkiste, 2009). However, autonomy isn’t equally valued across cultures, which raises the question of whether it’s truly associated with successful psychosocial outcomes. Some research has shown that in collectivistic cultures, being able to choose our own life experiences and make important decisions isn’t strongly linked to having a positive view of our life (Choi et al., 2023; Lambert et al., 2022). However, other research suggests this connection is more complex. Cross-cultural studies indicate that Chinese, European, South American, and North American teenagers and adults all associate autonomy with well-being regardless of whether their larger culture values personal choice (Chen et al., 2015).

Feelings of competence don’t come only from success. After being diagnosed with terminal cancer, computer science professor Randy Pausch delivered a life lessons speech known informally as “The Last Lecture.” In it he described a situation in which his childhood football coach had pushed him hard during one practice, making him drill repeatedly:

And when it was all over, one of the other assistant coaches came over and said, yeah, Coach Graham rode you pretty hard, didn’t he? I said, yeah. He said, that’s a good thing. He said, when you’re screwing up and nobody’s saying anything to you anymore, that means they gave up. ... Your critics are your ones telling you they still love you and care (Pausch, 2007, p. 5)

Rather than interpreting criticism as a sign of failure and becoming discouraged, Pausch realized this feedback provided an opportunity to increase his competence and was able to use that insight throughout his life to achieve his goals and increase his chances of evaluating his life as successful.

Relatedness

Relatedness, the feeling of being connected to others, is also commonly viewed as part of a successful life ( Figure 17.20 ). Our relationships include not only contact with others, but also the emotional connections we build and the extent to which we feel other people understand us. For example, in the excerpt from Pausch’s speech, the coach’s words sent the message that Pausch was respected, valued, and worthy of an honest opinion. This broad definition matters because it accounts for the variety of bonds in adult lives. Isolation, physical or emotional, may prevent people from feeling they have lived successful lives, perhaps because it makes them more likely to dwell on negative life events without being able to get reassurance from others (van der Keep-Deeder et al., 2022).

“Mr. J.” was a fifty-three-year-old terminally ill man being interviewed for Kübler-Ross’s research regarding the themes of grief when he said the following:

You know, it’s a wonderful feeling, but everywhere I have been and all through my life, people have liked me. I am profoundly thankful for that. I am humbly thankful. I have never gone out of my way, I don’t think, to be a do-gooder. But I can find any number of people in this city who could point out times on various jobs that I helped them out. . . . But by the same token everybody I have ever known has helped me. I don’t believe I have an enemy in the world. (Kübler-Ross, 1969, p. 135)

Mr. J looked back with satisfaction not only on what he had done for others, but also on what others had done for him. He clearly felt he had been successful at establishing connections throughout his life.

A Good Death

We’ve described a “good life.” How do we define a good death ? Many factors are relevant, including experience, relationships, community, culture, and history, and religious and medical resources. Before the twentieth century many people died of acute causes such as infectious diseases, and treatments for conditions like cancer weren’t readily available. Death was generally public, meaning community members were often present helping the patient and family, and the process was managed by relatives instead of professionals (Cottrell & Duggleby, 2016). When professional help was needed, religious figures were often more likely to be called than doctors (Walter, 2003).

Cottrell and Duggleby (2016) describe the modern Western notion of a good death as one that is peaceful, dignified, pain-free, and occurring in old age, at home, with enough time to prepare (such as by drawing up a will), but not so much time that the death is prolonged.

Pain and Suffering

The desire to be free of pain and suffering is a common theme in a good death in Korean (Kim, 2019), Buddhist (Dorji & Lapierre, 2022), Swiss (Borrat-Besson et al., 2022), Chinese (Liu & van Schalkwyk, 2018), and South African cultures (Daniels-Howell, 2022) as well as in diverse populations of elders in the United States (Cain & McClesky, 2019). There is no universal agreement about how this freedom should be accomplished, however.

In one study, Black and Latino adults in the United States viewed medical aid in dying ( MAID ) negatively, perhaps because their religious backgrounds emphasize suffering as spiritually necessary or because they were concerned about this aid being overused with minority populations (Cain & McClesky, 2019). Similarly, Buddhists and Muslims regard death as unavoidable and may reject aid in dying because they feel it violates that aspect of their faith (Dorji & Lapierre, 2022; Nadeem et al., 2017). Given the Christian belief that events are “in God’s hands,” aid in dying may be viewed as going against God’s plan (Daniels-Howell, 2022). Kim (2019) cites data indicating that 90% of Korean elders support end-of-life measures and don’t want to prolong life artificially; however, the Korean culture frowns on suicide, which may affect the way aid in dying is perceived. Judaism emphasizes the value and sacredness of human life, which may lead Jewish doctors to recommend more aggressive medical treatments and Jewish patients and families to request them (Braun et al., 2014). “In defining a good death across research on patients, loved ones, and health care providers, 81% feel that being free of pain is a top priority (Meier et al., 2016).

The related question whether a sense of control or autonomy is associated with a good death doesn’t have a consistent answer either. In collectivistic cultures such as Japan’s, the patient’s specific wishes may not be solicited or heeded (Terunuma & Mathis, 2021), but in more individualistic cultures, respecting the patient’s autonomy and individual preferences is seen as a fundamental part of a good death (Lang et al., 2022; Vanderveken et al., 2019, Borrat-Besson et al., 2022; Cain & McClesky, 2019).

In religious traditions that emphasize the inevitability of death, such as Buddhism and Islam, personal choice in the matter may be viewed as irrelevant (Dorji & Lapierre, 2022; Nadeem et al., 2017). In contrast, Israeli doctors indicated in one study that they feel their primary duty is to preserve life, which may cause them to place less emphasis on patient autonomy in end-of-life decisions (Braun et al., 2014). However, many cultures share the desire to be prepared for death—whether simply emotionally or tangibly, such as by making a will (Borrat-Besson et al., 2022; Dorji & Lapierre, 2022; Liu & van Schalkwyk, 2019; Nadeem et al., 2017) ( Figure 17.21 ).

A good death can also include respectful treatment after death . In their recent study of COVID-19 pandemic deaths, Hernández-Fernández and Meneses-Falcón (2023) noted that health-care and funeral workers expressed concerns about not being able to treat bodies respectfully after death, partly because of practices intended to prevent the spread of disease (such as spraying the body with disinfectant), but also because the sheer number of deaths during the first year of the pandemic overwhelmed them.

Connections

Family relationships and friendships are another common theme across cultures. For example, Swiss, Chinese, and Korean research participants indicated that being with loved ones, especially children and grandchildren, was a high priority during the dying process (Borrat-Besson et al., 2022; Kim, 2019; Liu & van Schalkwyk, 2018). However, this isn’t always possible. During the pandemic, many people died separated from their families, and even if families were present, they were likely wearing masks and other protective equipment, which may have created a sense of distance and increased distress for everyone.

The impact of the person’s death on their family is also relevant. In the Confucian value system common to countries like Korea and China, having a good death includes feeling you have been a good parent and are not a burden to your family (Kim, 2019). For Muslims and others living in India and Uganda, a good death requires ensuring that the surviving family will be financially secure (Krikorian et al., 2020; Nadeem et al., 2017).

The Age of the Deceased

The concept of a “good death” often assumes that death happens in older age. However, that is not always the case. Parents of terminally ill children often experience distress at not being able to alleviate their child’s pain and report not always receiving good communication from medical staff. Health-care workers report avoiding discussions about the child’s impending death in a well-meaning but often unsuccessful attempt to prevent further distress (Daniels-Howell, 2022).

Children have less autonomy and understand death differently than adults, so we can’t assume that adult standards for a good death apply to them. Studies suggest that health-care workers can improve the death experience for sick children and their families by treating the child not as a patient or diagnosis but as a person (including allowing everyday childhood activities such as attending school and playing), communicating clearly with families, and providing as much family time as possible, such as by allowing parents and siblings to participate in the child’s care if feasible (Broden et al., 2020; Daniels-Howell, 2022) ( Figure 17.22 ).

Spirituality and Religion

Religious and spiritual views may also help define a good death, regardless of what that religion is. Many religious and spiritual perspectives regard death as inevitable and controlled by a force outside the individual, and therefore not to be feared (Cottrell & Duggleby, 2016; Krikorian et al., 2020). In Buddhism, for example, death is a natural event to be approached calmly. Performing altruistic acts during life is believed to enhance progression toward enlightenment, so we are constantly preparing for death by being alive (Dorji & Lapierre, 2022). Engaging in specific religion-related practices may also contribute to a good death. In Hinduism, a good death is associated with rituals such as moving from the bed to the floor and fasting. These deeply held traditions are meant to prevent misfortune from happening to the dying person’s family but may be hard to accomplish in hospital settings (Kim, 2019). However, lack of religious or spiritual beliefs does not necessarily indicate a “bad death.” In fact, people at extreme ends of the religiosity continuum (i.e., people who are either very religious or very nonreligious) show similar acceptance of and lack of anxiety about death (Spitzenstätter & Schnell, (2023). People who are agnostic or atheistic tend to regard death simply as the end of existence, with no afterlife to be concerned about, and to regard life as being meaningful and valuable as a result. They may be distressed because they feel the language and rituals surrounding death have unwanted religious overtones, but do not typically adopt religious views in response (MacMurray & Fazzino, 2017).

Concluding Thoughts

Death can be a challenging topic, not only because it’s associated with sadness, but also because it has many complex aspects and intersecting contexts. Dealing with death requires addressing the physical, psychological, social, cultural, and practical needs of the person who’s dying and of their loved ones. Sometimes that calls for difficult conversations. Sometimes we may have to make choices we wouldn’t want for ourselves, but in doing so we are honoring someone else’s wishes. Sometimes we’re called upon to give support to others when we may also need it. Even when we can regard death as the end of pain and suffering, or perhaps the attainment of a spiritual destiny, death is typically distressing.

However, it is an unavoidable part of life. Since we can’t avoid it, we can try to understand some of the factors that affect the way people experience and cope with it. We can understand the options available to those who want to ensure their designated loved ones know what to do before and after their death. We can make ourselves more aware of cultural factors that may influence what people want the end of their lives to look like. We can use this information to help ourselves as well as others. Although it’s hard to be fully prepared for death, we can use this knowledge to approach it with a sense of being informed and prepared for the challenges ahead.

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Reviewing and Reconciling Your Life Before You Die

As a dying person comes to terms with her own mortality and begins to prepare for death , she may use life review, or life reconciliation , as a way to find closure and a sense of completion.

A life review doesn't follow a predictable pattern, and no two people can be expected to experience life reconciliation in the same way. That said, there are five common stages of a life review that are helpful to understand: expression, responsibility, forgiveness, acceptance, and gratitude.  

Coming to terms with impending death is extremely difficult for most people. As a dying person moves through the DABDA stages of coping , many emotions surface that need to be expressed.   Anger is often the dominant emotion for a majority of this time.

It's important for a dying person to express whatever emotions they are feeling. Expressing intense feelings and releasing anger is essential to finding peace.   If a dying person is allowed complete freedom of expression, true healing on an emotional and spiritual level is possible.

A dying person might need explicit permission to express her anger.   She might fear that by expressing herself she will alienate loved ones. She might be angry at a higher power and feel ashamed of those feelings.   By expressing feelings of anger at the illness, at the unfairness of the world, or at a higher power, a dying person is preparing herself for peace and acceptance.

Responsibility

As the dying person reviews their life, they begin to realize how they have played a role in all that has happened to them.   They realize that their actions, thoughts, and lives are their responsibility alone. Most people describe this as a freeing experience. They come to know that they aren't to blame for their illness and that death doesn't mean they somehow failed in life. This realization of responsibility helps the dying person come to terms with all that has happened in their life and prepare for what's ahead.  

Forgiveness

When someone experiences true forgiveness, they release themselves from the bonds of hurt and bitterness.   Forgiveness isn't about accepting wrongful behavior. Forgiveness is about choosing to let go of the hurt and resentment that keeps us from living in peace.

A dying person may find it easy to forgive others for past hurts but may have a hard time forgiving herself.   He may wonder whether others can really forgive him for his wrongs, big or small. He may spend some time asking others for forgiveness, asking a higher power for forgiveness, and offering his own forgiveness to those who have hurt him.

In his book, The Four Things That Matter Most , Dr. Ira Byock discusses what most people define as being the most important things to say before you die: "Thank you," "I forgive you," "Will you forgive me," and "I love you." Two of the four phrases are about forgiveness, emphasizing how important it is to offer and receive it before we die.

Some people will choose to die in unforgiveness, and that's a valid choice. Many others choose to invite inner peace before they die by offering and receiving forgiveness.

Acceptance is the final stage in the DABDA theory of coping with death and is an important part of a life review.   We seem to have lost the reality that death is a natural process that will happen to each and every one of us, choosing instead to fight death valiantly until the end. When a dying person accepts their death as inevitable, they are not giving up on life but rather allowing the natural order of life to complete its circle.  

We don't have to like what we accept as reality, but accepting that life is indeed complete is an important step towards dying in peace. Just as a woman in labor can't be stopped from delivering her baby, the final dying process cannot be stopped once it has begun. When a dying person is able to accept their inevitable death, they are opening themselves up to experience peace and contentment in their last days.  

After experiencing other aspects of a complete life review, a dying person will often experience extreme gratitude for their life.   He will be thankful for the people in his life; the experiences he's had, whether good or bad; and may feel gratitude towards a higher power, if he believes in one, for the life he's had. He may express his gratitude to his friends and loved ones and feel overwhelming joy. This is how most of wish we could die, with a joyful heart and a spirit of peace.

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Tyrrell P. Stages of Dying . StatPearls [Internet]. Published June 3, 2019.

Williams R. Anger as a Basic Emotion and Its Role in Personality Building and Pathological Growth: The Neuroscientific, Developmental and Clinical Perspectives .  Front Psychol . 2017;8:1950. Published 2017 Nov 7. doi:10.3389/fpsyg.2017.01950

Houston RE. The Angry Dying Patient .  Prim Care Companion J Clin Psychiatry . 1999;1(1):5–8. doi:10.4088/pcc.v01n0102

Tangney JP, Stuewig J, Mashek DJ. Moral emotions and moral behavior .  Annu Rev Psychol . 2007;58:345–372. doi:10.1146/annurev.psych.56.091103.070145

Meier EA, Gallegos JV, Thomas LP, Depp CA, Irwin SA, Jeste DV. Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue .  Am J Geriatr Psychiatry . 2016;24(4):261–271. doi:10.1016/j.jagp.2016.01.135

Kyota A, Kanda K. How to come to terms with facing death: a qualitative study examining the experiences of patients with terminal cancer .  BMC Palliat Care . 2019;18(1):33. Published 2019 Apr 4. doi:10.1186/s12904-019-0417-6

Akhtar S, Dolan A, Barlow J. Understanding the Relationship Between State Forgiveness and Psychological Wellbeing: A Qualitative Study .  J Relig Health . 2017;56(2):450–463. doi:10.1007/s10943-016-0188-9

Ingersoll-Dayton B, Torges C, Krause N. Unforgiveness, rumination, and depressive symptoms among older adults .  Aging Ment Health . 2010;14(4):439–449. doi:10.1080/13607860903483136

Lotto L, Manfrinati A, Rigoni D, Rumiati R, Sartori G, Birbaumer N. Attitudes towards end-of-life decisions and the subjective concepts of consciousness: an empirical analysis .  PLoS One . 2012;7(2):e31735. doi:10.1371/journal.pone.0031735

Emanuel LL, Reddy N, Hauser J, Sonnenfeld SB. "And Yet It Was a Blessing": The Case for Existential Maturity .  J Palliat Med . 2017;20(4):318–327. doi:10.1089/jpm.2016.0540

Fox GR, Kaplan J, Damasio H, Damasio A. Neural correlates of gratitude .  Front Psychol . 2015;6:1491. Published 2015 Sep 30. doi:10.3389/fpsyg.2015.01491

By Angela Morrow, RN Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse.

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A ‘Life Review’ Can Be Powerful, at Any Age

Reflecting on the past, through writing or conversation, can help us better appreciate where we are — and where we’re going.

By Emily Laber-Warren

Jodi Wellman was devastated when her mother died of a heart attack at age 58. Cleaning out her apartment made her feel even worse. Drawers and closets overflowed with abandoned projects: unpublished manuscripts and business cards for ventures that had never gotten started.

“My mom was a wake-up call for me,” Ms. Wellman said. “She had these dreams that she didn’t act on.”

At the time, Ms. Wellman was in her early 30s, living in Chicago and working her way up the corporate rungs at a fitness club chain. But, over the course of five years, that work began to feel empty.

Determined not to stagnate like her mother, Ms. Wellman quit her job to become an executive coach, eventually entering a master’s degree program in positive psychology. There, she developed a strategy for living fully: Think about death, a lot.

Now also a speaker and the author of “You Only Die Once,” Ms. Wellman, 48, believes that focusing on how short life is makes you less likely to squander it. To help her clients figure out how to spend their limited time, she asks them dozens of questions, organized by life phase — things like what activities made them happiest as a child, and what they would change about their 40s and 50s.

Her approach is a twist on something called “life review,” where people systematically reflect on their past, through conversations or in writing, to identify character strengths and develop self-awareness and acceptance. The process can occur both with a partner or in small groups, and it typically unfolds in six to 10 weekly sessions.

Life review arose in the 1960s to help people at the end of their lives articulate and make peace with their legacies. But new research suggests that the process of reflecting on previous experiences has value for people at all ages, including young adults and bereaved children . The actress and activist Jane Fonda, now 86, spent the year before turning 60 conducting a life review that she said helped her recognize patterns and cultivate confidence.

“It’s not only looking back,” said Gerben Westerhof, the department chair in psychology, health and technology at the University of Twente in the Netherlands, “but also looking forward at who you are. What could be the next chapter of your life?”

Why life review helps

In the 1950s, Erik Erikson, the influential child psychoanalyst, published his theory that each stage of life is associated with a specific psychic challenge . The work of toddlerhood, for example, is to gain autonomy. The goal of young adulthood is to develop intimacy with others. Old age, he posited, is the time to gather one’s life experiences into a coherent narrative — what Mr. Erikson called integration. Those who fail, he wrote, risk falling into despair.

Dr. Robert Butler, the first director of the National Institute on Aging, built on Mr. Erikson’s concept. For older people who get stuck on regrets or disappointments, Dr. Butler proposed something called life review therapy.

Life review has since been studied in many contexts, such as in people diagnosed with cancer or facing terminal illness, as well as with older people in adult day care facilities or nursing homes . And research suggests the process has many potential benefits, like reducing depression and anxiety and increasing life satisfaction .

“As people get older and they retire, they lose a sense of purpose sometimes,” said Juliette Shellman, an associate professor at the University of Connecticut School of Nursing. Life review, she explained, can give people “the opportunity to sit back and look at their accomplishments.”

How life review works

A traditional life review unfolds through one-on-one or group conversations with a therapist or facilitator who helps people explore their childhood, their teenage years and later life stages. The facilitator asks questions designed to prompt reflection, like “Do you remember your first attraction to another person?” and “What pieces of wisdom would you like to hand down to the next generation?”

The facilitator’s role is to build trust, offer interest and try to reframe difficult passages in a more positive light, said Dr. Shellman, who also serves as the director of the International Center for Life Story Innovations and Practice. For example, a facilitator might help someone who experienced the death of a child explore the positive memories amid the tragedy.

The process begins by listening “in an appreciative way,” Dr. Westerhof wrote in an email. “Next we make offers for alternative views,” he explained, but the life reviewer has to determine whether those views are appropriate.

One of the most popular forms of life review is guided autobiography, whereby weekly sessions are organized thematically rather than chronologically — things like family, money, work, health. Each week, the facilitator preps participants for the following week’s theme with questions such as: “How did you get into your major life’s work?” or “Do you regard yourself as generous or stingy?” Participants pen brief autobiographical vignettes between sessions and read them aloud to one another.

Writing your story and having people hear it can be powerful, said Cheryl Svensson, the director of the Birren Center for Autobiographical Studies. Some guided autobiography groups continue meeting on their own for years.

Not only for late life

Though life review has been studied mostly in older people, there’s evidence that this kind of intervention can benefit people at any age. In a 2022 study from Australia , 18 to 29 year old people participated in group sessions where they shared two important memories and were coached by the facilitator to add more detail and connect with what they were feeling at the time. Follow-up assessments showed that recalling these positive memories in detail increased self-esteem, optimism and sense of meaning in life.

Dr. Westerhof and a colleague recently completed a small study, as yet unpublished, in which adults ages 19 to 73 who were dealing with divorce, sudden illness, a new job or a breakup found relief from anxiety and depression after participating in a self-guided form of life review.

“Life transitions tend to put everything upside down,” Dr. Westerhof wrote in an email. “The things that were important before are perhaps not that important anymore. Life review helps people accept changes and also to search for new commitments.”

How to conduct a life review

You can work with a professional. The Birren Center for Autobiographical Studies has certified hundreds of guided autobiography instructors , who run in-person and remote classes. Instructors typically charge up to $250 for a five- to eight-week program that involves weekly writing assignments, although prior writing experience isn’t necessary.

For a classic life review that unfolds as a conversation, the International Center for Life Story Innovations and Practice at the University of Connecticut can recommend a trained therapeutic listener .

You can D.I.Y. For a classic life review, Dr. Shellman suggested reading “The Handbook of Structured Life Review” by Barbara K. Haight and Barrett Haight, which explains how to be a therapeutic listener and provides questions for each life stage.

“Writing Your Legacy” by Dr. Svensson and Richard Campbell explores how to pursue a guided autobiography on your own and includes dozens of additional themes, including life values, food and drink, passions, friendships and cultural heritage.

Try including pictures or props. Keepsakes, photos or even poems can help spark recollections, said Bonnie Kellen, a New York City-based psychologist and life review therapist. And listening to music associated with an earlier time or returning to a location from your past can help, Dr. Shellman said.

Look out for difficult emotions. Deena Hitzke, a psychotherapist from Tucson, Ariz., uses life review to help people recover from trauma. She finds the format useful because so much of our ability to adapt and grow “depends upon the narrative that we’re telling ourselves about who we are,” she said. But not all life review facilitators have clinical training. If you find the process is stirring up difficult emotions, Dr. Shellman suggested consulting your doctor or nurse practitioner.

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Life Review, Essay Example

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Reflective Statement #1

During the interview, the physical appearance of the client due to his car accident, which left him with a crushed jaw and blindness in one eye, appeared to be a severe setback for the client during his teenage years, and this appeared to be a very frustrating and difficult time for the client, as he required much rehabilitation to promote his recovery. This was a trying experience on many levels, but it enabled him to become a stronger and more resilient person in his later years.

Reflective Statement #2

The client’s personal experiences with alcohol abuse were many, including his father, his ex wife, and his own misuse. However, the client’s recognition of his own problem and how others in his life impacted his own wellbeing are important indicators of his level of strength and courage in many ways. The client has witness many hard times firsthand, yet he exhibits a remarkable spirit that has enabled him to overcome some of the obstacles he faced in his younger years.

Reflective Statement #3: The client faced considerable challenges in his efforts to maintain strong relationships with his sons, but his emotional and psychological wellbeing has improved with his commitment to attending AA meetings on a regular basis. In addition, he has experienced a rebirth of sorts through the involvement of his sons in the family business, which continues to be strong, in spite of challenges along the way. Therefore, in spite of the client’s physical limitations, he remains committed to the family business, and to communicating with his sons to improve his own level of happiness and contentment throughout his own life.

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Purpose and the Life Review

Purposeful people look to goals they seek to accomplish over the long haul..

Posted July 28, 2021 | Reviewed by Lybi Ma

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• Rather than dwelling on past problems, imagining a hopeful future can shape our development in more agentic and adaptive ways.
• The capacity for looking forward with a life-fulfilling purpose requires looking backward in an open and receptive way.
• A life review is for reconstructing the past in a manner that can provide personal benefits that many of us need.

As a helping profession, psychology from its inception has sought ways to counsel people for the challenges of coping with distress, self-discovery, and personal growth. Original stabs at solutions to such challenges focused on unresolved conflicts of the past. Sigmund Freud dredged the depths of patients’ memories to repair injuries that had never healed because they had been suppressed rather than recognized. The idea behind this reconstruction work: cleaning up a painful history could disinfect sores that were still hurting, perhaps even more intensely than at the time they were inflicted.

Psychology’s cognitive revolution in the latter half of the 20th century directed more attention to a person’s present mode of experiencing the world. Cognitive psychologists were uncomfortable with the idea that people are chained to their pasts and driven by events that they can’t even remember. The cognitive view of human nature is more active and more skill-based. If people can be encouraged to think about their lives in more rational, stable, and positive ways, they become better able to cope with problems and seize opportunities in the present. Embodied most notably in cognitive behavior therapy (CBT), the cognitive approach has been reinforced by the spread of compatible spiritual ideas and practices from Eastern traditions. Meditation and various forms of yoga emphasize the value of “being present,” offering engaging methods of focusing the mind towards that end. For those with a bent towards classical philosophy in the Western tradition, CBT shares the Stoic belief in our power to define, control, and improve our experiences by building strong habits of mind and employing these habits to gain emotional stability in the present.

Most recently, psychology’s focus has shifted to the influence of the future—or at least future aspirations—on identity and self-development. The theoretical foundations for this focus have been established by psychologist Martin Seligman ’s writings on what he calls “prospective thinking.” By imagining hopeful future prospects we can shape our development in more agentic and adaptive ways than we could by dwelling on our past problems, and to a much more salutary effect.

My own writings on the development of purpose are most closely aligned with the notion of prospective thinking. Purpose, which I’ve defined as “an active commitment to accomplish aims that are meaningful to the self and of consequence to the world beyond the self,” is future-oriented by nature. Purposeful people look ahead to goals they seek to accomplish over the long haul. The psychological benefits of purpose lie in strengths that forward-looking commitments bring: motivation , energy, achievement, hope, and resilience . Purpose is a prime example of how a person’s future aspirations can shape the person’s self-development. In every age period, I have studied, from adolescence to advanced age, purpose stands out as a key to positive living.

Still, the past does matter—especially how we think about the past. Faulkner was right when he wrote, “The past is not dead; it is not even past.” The capacity for looking forward, with renewed commitments to life-fulfilling purposes, requires looking backward in an open and receptive way.

This was brought home full force by a revelation late in my life that changed my understanding of how I came to be the person I am. Briefly, I discovered that my father – who I once assumed was killed or “missing” in World War II – had a substantial career abroad after he abandoned my mother and me. Most startlingly, I found that my mother, who never spoke with me about him, had arranged my early schooling in line with my father’s, an educational choice that turned my life in the direction it has taken. Not only did my discoveries shake up my sense of identity, it uncovered a host of regrets, resentments, and confusions that had long unsettled my emotional state. 1

My own prior work on purpose development was not sufficient for the self-examination I felt compelled to carry out. For this, I adopted the personal narrative approach known as “the life review.” A life review is a structured procedure for reconstructing our pasts in a manner that can provide three personal benefits that many of us need as we grow older:

• An acceptance of the events and choices that have shaped our lives, reflecting gratitude for the life we’ve been given rather than self-doubt and regret
• A more authentic (and thus more robust) understanding of who we are and how we got to be that way, reflecting the highly developed, reassuring sense of self that psychologist Erik Erikson called “ego integrity”
• A greater clarity in the direction our lives should take going forward, reflecting what we have learned from the experiences and the purposes that have given our lives meaning in the past.

The “life review” method was pioneered by Robert Butler, a legendary psychiatrist who was concerned with the problem of increasing depression in aging patients. Butler believed that the depressive symptoms of his patients stemmed from the aimless way they remembered their pasts. He devised a procedure for helping people conduct “life reviews” that highlighted the key purposes they had pursued successfully in their prior stages of life. By finding positive benefits in all earlier experiences—even ones that appeared unfortunate at the time— people can affirm the values of their lives and chart a hopeful path forward.

Before he was able to fully develop this method, Butler moved on to a celebrated career in gerontology. He founded the National Institute of Aging and wrote a Pulitzer-Prize-winning book on successful aging. He never found the time to return to his innovative “life review” idea prior to his 2007 death. Late in his life, Butler wrote that he regretted this, because he believed the idea would prove useful for all people in the search for ways to live maximally meaningful lives—whether or not battling depression, and whether old or young.

Butler believed that reflective life reviews would promote “intellectual and personal growth, and wisdom ” throughout the lifespan. Among the psychological benefits he noted were: the resolution of old conflicts; an optimistic view of one’s future; “a sense of serenity, pride in accomplishment;” a “feeling of having done one’s best;” a capacity to enjoy present pleasures such as humor , love, nature, and contemplation; and “a comfortable acceptance of the life cycle, the universe, and the generations.” This, of course, is a compelling list of the main pillars of psychological health.

In particular, my life review has two paradoxes regarding psychological development in the adult years of life:

• The capacity for looking forward in a positive way requires looking backward in an open, undefended, and honest way, with past memories structured by one’s present values and future aspirations.
• Autobiographical discovery deepens a person’s understanding of self while broadening the person’s knowledge of others who have influenced the formation of self, often in previously unknown ways.

The search for purpose never ceases. As we age, we entertain new aspirations and take on new commitments. In doing this, we draw on interests and capacities we developed earlier in life. The accomplishments of our early years can set the stage for a later life of meaning, fulfillment, and contributions to the common good. A life review can bring all of this into focus, accelerating the discovery of our “encore” purposes and affording new satisfaction as we look back at the driving forces of our earlier life.

Purpose is a lifelong need, as relevant as we age as when we are young. We may imagine it will be a straight line when we look forward as young people. But when we look back, we see it as more evolving, more meandering, and less predictable: our purposes change as we adapt to our changing circumstances and those of the world at large. A life review offers us a way to look back and connect the dots, starting with our first glimmers of purpose in adolescence. It can help us recall the purposes we’ve had in our lives, integrate them with our present circumstances, and envision opportunities for further purposeful work.

Our pasts do matter; and it is essential to attend to our present experience and our future aspirations as well. Each school of psychology has an essential point to make: past, present, and future all play a part in shaping a person’s perspectives on self. The message that we should take from psychology’s approaches is that all the times of our lives, from our remembered origins to our imagined futures, provide us with material for self-definition and potential growth. It is up to us to actively search through this material and integrate what we find into a coherent, authentic, and gratifying vision of who we have been, who we are, and who we aim to be.

1. I tell the full story of my discoveries and how I dealt with them psychologically in my new book “A Round of Golf with my Father: The New Psychology of Exploring Your Past to Make Peace with Your Present.”

William Damon, Ph.D. , is a professor at Stanford University, director of the Stanford Center on Adolescence, and senior fellow at Stanford University's Hoover Institution.

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