Crossroads At Midlife; Your Aging Parents, Your Emotions, and Your Self (Book Review)

Author:  Praver, Frances Cohen
Publisher:  Praeger
Reviewed By:  Isabelle Reiniger, Winter 2008 (Vol. XXVIII, No. 1) pp. 41-43

Frances Cohen Praver’s book Crossroads at Midlife addresses a very specific time in life when adults are faced with their parents’ need for care taking due to aging and illness. Although this is a very specific problem, she addresses many problems that people at all stages of life face (such as feeling guilty, needing self care, and revisiting childhood issues). Due to the book’s narrow focus fewer readers will read this book despite the fact that many people will eventually be faced with taking care of their parents. Some will not attribute their problems to the care taking of a parent. Then again, some faced with the struggles caring for a parent will be glad to find a book that specifically addresses their issues.

Initially, Cohan Praver’s book felt refreshing due to her frankness and her willingness to be personal. She makes clear that not only does she have a lot of professional experience working with people who are taking care of their aging parents, but that she herself was faced with the logistics and feelings that arose out of her own mother’s struggles with cancer. She aligns herself with the reader rather than take the more removed stance of the expert.

However, I soon experienced her style as too chummy with sentences like: “The bad news is—well, you know that—your elderly parents are failing,” or later “Maybe the bad news is not so bad after all. Hang on.” Sometimes this casual tone can work, but there seemed to be too much of it right from the start. This sense of chumminess was probably intensified by Cohen Praver’s choice of opening. In the chapter titled “Getting Your House in Order” she begins to talk about the midlife person’s changes. In the span of two paragraphs she mentions changes in memory capabilities, physical appearance, health issues, sleep patterns, and weight. She then devotes two whole paragraphs to the reduction in female and male sexual functioning with a tone that also felt too informal (e.g., “Sorry guys, it does not get bigger faster”) and her first case description is of a couple with sexual problems. Clearly sexual dysfunction can be an issue that arises in midlife, yet the placement of the issue in the book’s opening section seems gratuitously titillating and ultimately misleading because sexual dysfunction is only a tangential issue compared to the main theme of the book.

Cohen Praver’s book is mostly based on many rich case examples and is not overly theoretical. Again, this can make it very useful for the general reader seeking some understanding and support. When Cohen Praver does discuss theoretical concepts she does not try to avoid psychoanalytic jargon or complex concepts. This could be seen as a compliment to the reader, whom she assumes will be able to follow. However, I was not sure if a reader without some knowledge of psychoanalytic theory would be able to follow her elaborations. For example in the chapter “Role Reversal,” Cohen Praver discusses how children and many adults have the desire to merge with an all-powerful parent. After a case example, she explains that the adult children taking care of their ill parent might be overly invested in keeping the parent from dying due to the unconscious wish to maintain the merger with the parent. The quality of the life of the parent might be diminished by poor care giving choices because of the unconscious underlying motivation. This idea is very rich and certainly potentially very helpful for those who manage to follow her, but it did not seem to be elaborated on enough to be accessible to all readers. This is, of course, where the many and detailed case descriptions can help out. They provide examples for the concepts she explores. One major benefit of the case descriptions she uses is that anybody in the role of the caretaker reading this book will recognize him or herself in at least one of the people whose emotional turmoil is described. Cohen Praver seems to have had a strong need to end each case description very neatly. Most of them end with a paragraph that summarizes the great progress they a made and how their life has changed for the positive. Her intention may have been providing a sense of hope to the general audience, rather than leaving them with questions about an open ending.

As I was reading Cohen Praver’s book I was having a tough time keeping the overarching structure of the book in mind. Each chapter seemed to have too many subheadings and each subheading immediately seemed to delve into a clinical case. Though these are vivid and entertaining, I felt too zoomed in and began to lose the big picture. Maybe my sense of feeling overwhelmed is a reflection of Frances Cohen Praver’s style. However, this could be a kind of parallel process and therefore a reflection of the challenges she is trying to describe in her book. She does make very clear that midlife adults are usually faced with a multitude of personal, professional, and familial challenges that can be overwhelming.

An enjoyable aspect of Cohen Praver’s writing is that she is passionate about her work. This comes across in statement such as “My work does wonders for me!” She clearly conveys a sense of complete trust and excitement in the psychoanalytic process. Though statements such as “Psychologists/psychoanalysts, who love you in totality, facilitate emotional development and feelings of self-worth” might raise questions in the general reader who does not expect to be loved by their therapist, overall, the tone of such passages conveys a sense of hope.

The book does a good job in promoting psychoanalysis and psychoanalytic psychotherapy. It is therefore an important book for the popular market.

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