• Psychotherapist Sue Cowan-Jenssen reflects on the Biden and Trump presidential debate, and what it tells us about the dangers of our broader tendency to deny the effects of ageing

I watched, along with millions of others, with dismay at President Biden’s debate against former President Trump. For a long time, I assumed that Biden might be looking frail and fragile but was cognitively competent. The strength of the denial from the White House was rang hollow.  

As one commentator said, most of us will have witnessed the cognitive failings of a loved one at some point in our lives. We know what we are seeing. The collusion of Biden’s close family was also disturbing. Is it the loss of power they fear or is it also that it is so very difficult and painful to tell a loved one that they are no longer able to function in the way they were?  

I have worked with clients when a parent has developed Alzheimer’s. What can be so distressing is if the parent lacks any awareness of their illness. This means it is difficult to get them to agree to having tests or treatment or perhaps carers in their home because they can no longer cope. Most difficult of all is reaching an agreement that they need to be in the safer environment of a care home. Even before the symptoms become severe, there are painful losses to face such as losing a driving licence which can feel devastating.

In my own area of work, psychotherapists find it very difficult to talk to a colleague when they see that they are no longer able to function as a therapist as well as they did. You are in effect telling them that their meaningful work, which very often has been a central part of their life, should come to an end. Old age might bring wisdom, but it will also bring decline. It is one of the reasons that professional associations such as the UKCP carry out regular audits so that a therapist who is failing can be identified. But it is not easy. 

I am putting this in the context of President Biden. Clearly politics has been his life and clearly his family do not have the stomach for helping him face the facts that he is no longer able to do the job for four more years. Is it the loss of their own power that makes it so difficult or is it also the pain of acknowledging a devastating truth which will be taking something away from a man you love? The resistance to the truth must be enormous. It is blatantly clear that if Biden refuses to step aside and loses the election, his political legacy will be ruined. He will be remembered as the man who was too vain and arrogant to let go of power and who lost the democrats the election. He will not be forgiven.

In the UK Anthony Eden is remembered for the failure of his foreign policy over Suez in 1956. It is forgotten that he was a decorated soldier in the First World War, and he was a successful Foreign Secretary during the Second World War. His achievements paled into insignificance against the failure of his foreign policy in 1956. How much worse will it be for Biden if he loses the election against Trump?

How we treat ageing is an issue for us all. We advertise ‘anti-ageing’ creams and potions as if age was a crime to be hidden at all costs. As a culture we have become better at talking about physical illness and even mental illness, but cognitive decline is the shameful ‘elephant’ in the room. We all dread it and I suspect it will remain so until or if we have better treatments for it. Fear, rage and denial are preferred to acceptance but until we are better at acceptance we cannot begin to appreciate what we do still have and what we can still do.

My mother-in-law at the end of her days, diminished and bedridden, when hearing of the death of an old friend said she wasn’t yet ready to die. When asked what she lived for, she said she still enjoyed the wind in her face and the taste of fresh raspberries. It was a relief to hear that she could still find pleasures in her albeit very limited life. Unlike many elderly people, President Biden could have a full and interesting life as a former President. By stepping aside gracefully, he would have the opportunity to contribute a sense of dignity to the realities and limitations of ageing that will affect all of us who are lucky enough to reach old age. 

Sue Cowan-Jenssen is a verified Welldoing therapist in London and online

Further reading

How to manage news-induced anxiety

How social and political forces shape our identity

Should therapists let politics into their consulting rooms?

Politics, psychotherapy, and boarding school