Edited By Josefa Ros Velasco
11 Rewriting Mecca: Teaching about Late-Life Depression Using John Metcalf’s “The Years in Exile” (Lucia Gagliese (York University, Ontario))
11 Rewriting Mecca: Teaching about Late-Life Depression Using John Metcalf’s “The Years in Exile”
York University, Ontario
Although late-life depression is common, many mental health professionals do not receive adequate training in its assessment or management. Engagement with literary narratives to develop psycho-literary case studies may be an innovative approach to enhancing knowledge about aging and mental health. John Metcalf’s short story, “The Years in Exile,” is a subtle, sophisticated depiction of depression in a retired writer. This chapter illustrates the development of a psycho-literary case study of Metcalf’s protagonist, including assessment, diagnosis, case formulation, and treatment planning consistent with lifespan developmental models and narrative frameworks. At each step, empirical and clinical research and theory are interwoven to highlight opportunities for evidence-based experiential learning.
Depression is experienced by 10 to 38% of people over 60 years old (da Costa Lane Valiengo et al. 2016). Mild to moderate depression is most common, but over 10% report severe symptoms (da Costa Lane Valiengo et al. 2016). It is persistent and associated with decreased quality of life, increased physical, cognitive, and social impairment, as well as increased mortality, including suicide (da Costa Lane Valiengo et al. 2016; Casey 2018).
Depression may be more complicated in older than younger people due to comorbid illnesses and atypical presentation. Specifically, older people are less likely than younger people to experience overt sadness and guilt but more ←179 | 180...
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