Abstract
The experience of depression is diverse based on social locations and context. This analysis is based on 45 interviews with primarily working-class depressed elderly women who were recruited in primary care clinics in northern central California. They explain their emotional distress by referencing biological and social factors associated with losing a productive self based on domestic labor and the caregiving of others. Some women redirect the trajectory of their distress by resisting hegemonic femininity. However, their efforts lead to a pariah femininity that they are neither fully at ease with nor that resolves their emotional distress. For a few women an alternative discourse of a dignified feminine self emerges in the context of friendships and faith. Depression in working-class elderly women can be characterized by an ongoing negotiation of limited statuses and roles in which control over one’s self is paramount.
Introduction
Two women, two stories: I used to cook a lot and bake a lot and have [everyone] over and help with the kids. And now I forget I can only do two things at one time. Before, I used to have the whole stove [going], doing this, helping with that problem and that other problem. I can’t do that anymore. It’s kind of like you feel worthless because you can’t do it anymore . . . and things keep going south from here . . . (African American, age 73) I don’t know what they [family] expect me to do. I guess jumping up and doing everything like before . . . why am I supposed to do it now? They [family] don’t understand me or they want me to be somebody I’m not. I’m not going to do it. I’m going to say what I want to say, and I am going to do it the way I want to do it. (Latina, age 68)
As these women reflected upon the challenges of contemporary aging, they did so from a shared place of having symptoms of, or being treated for, depression. And while their concerns may be familiar to younger and middle-aged women, their stories of aging and emotional distress also speak to the socially negotiated nature of femininity. Based on interview data from a mostly working-class, ethnically diverse group of elderly women, I contextualize their emotional distress against the loss of a self that rested primarily upon domestic labor and caregiving. While aging can precipitate depression in both men and women, each is grappling with recasting a self once embedded in different institutional settings and conceptions of productivity. For older women, this is more likely the domestic sphere of home and family, whereas for men, it is the public sphere of their work and employment. But for women, aging may also be associated with a degree of liberation inaccessible to men insofar as they no longer must compete with other women for men’s approval. While older men may find themselves struggling for the approval of other men given their loss of work and breadwinner status (Apesoa-Varano, Barker, & Hinton 2015; Apesoa-Varano, Barker, & Hinton 2018), older women may find more opportunities than when they were younger to develop closer female friendships and independent community relationships that support a dignified feminine self (Cruikshank 2013; Hurd 1999).
Specifically, might the demise of self that Thomas J. Scheff (2001, 2012) and others posit as a precursor to depression open a path toward a more dignified self for women? Put differently, if losing a productive self among men means losing a master status of value (Apesoa-Varano, Barker, & Hinton 2015; Apesoa-Varano, Barker, & Hinton 2018), does it mean the same for women? Although some women in this study endured shame from this loss, others found relief from memories of an abusive past and affirmation of a dignified self. The question then becomes what factors might tip the emotional scales in one or the other direction? Some women I interviewed drew upon an isolating discourse they were neither fully comfortable with nor tempered their emotional distress. Other women coped more successfully through redefining (without severing) their role with family, nurturing relationships with other women, and becoming involved in community institutions. Contrary to the view that elderly women suffer yet again from aging bodies that do not “live up to” the patriarchal expectations afflicting younger women, for some aging represents a retreat of the body in ways that may have shamed them but may now also liberate them (Silver 2003; Twigg 2004). In this article, I analyze how these elderly women struggle through the complex intersection of social class, ethnicity, and gender to assert control over their lives. Regardless of which self is ascendant in their stories of pain and loss, these women are grappling with being the authors of their own lives.
Background
Women, Emotional Distress, and Depression
Epidemiological studies find that women are at greater risk than men to develop depression and are more likely than men to be treated for depression (Kessler et al. 2005; Pratt and Brody 2014). Mexican American and African American women show lower rates of depression treatment compared with white women, yet they suffer from equal or higher levels of emotional distress than previously thought (Beauboeuf-Lafontant 2007; Pratt and Brody 2014). Still, there are gaps in our knowledge of late-life depression diagnosis and treatment, especially of minority older women (Biegal, Farkas, and Song 1997; Gatz and Fiske 2003; Nadeem, Lange, and Miranda 2009; Stockdale et al. 2008), and the informal influences (e.g., family) on formal depression care seeking (Duncan, Best, and Hagen 2009; Gil 1996). Without denying the role of biological and psychological factors, sociologists such as Scheff (2001, 2012) and George W. Brown and Tirril O. Harris (1978) have offered explanations of depression that substantially integrate its social origins and contexts (see also Pilgrim and Bentall 1999).
Scholars have long argued that experiencing depression can devastate the “self,” and this is precipitated by tenuous social bonds or the absence of a supportive community (Karp 1997; Thoits 2013). Scheff (2001) proposed that receding social connections lead directly to feelings of sadness, anger, and ultimately shame. As this shame deepens, an “unworthy” self-concept develops. Scheff (2012) further argues that depression is linked to the absence of positive memories about past relationships or membership in a community. While this theoretical framework highlights the main socioemotional dynamics of distress, it overlooks how key social locations such as gender impact the depression experience.
Feminist scholarship has answered this call by questioning the underlying assumptions of the epidemiology of women’s depression and its medical treatment (Bondi and Burman 2001; Travis and Compton 2001; Ussher 2010). There have been two lines of feminist critique of the mental health (specifically, psychiatric) literature. Among those arguing that women’s oppression is all encompassing, scholars have proposed that sadness is not only medicalized but also feminized to control women in the service of men. For example, Linda M. Blum and Nena F. Stracuzzi (2004) argue that the U.S. cultural apparatus reproduces patriarchy through latent gendered messages compelling women, primarily productive-age elite women, to engage in antidepressant consumption to maintain “female fitness” in a postindustrial, volatile labor market. From this perspective, women cannot resist and shape the course of their emotional wellbeing due to gender socialization and patriarchal oppression (see also Chesler 2005; Micale 1995). In the context of hegemonic masculinity, this “emphasized femininity” entails acts of compliance and complicity (e.g., pleasing others, pursuing approval, seeking relationships) to ensure men’s interests and desires (Connell 1995; Connell and Messerschmidt 2005; Kimmel 2012).
Another line of reasoning holds that women exercise a degree of independence and agency within this oppressive social system and culture (Bluhm 2011). Here, women’s emotional rumination is how they genuinely see themselves—an authentic reflection of their felt feminine selves and not simply being “falsely conscious” or duped about their identities and roles under patriarchy. The potential for agency reframes women not as mere victims but as decision-making actors struggling with their emotional distress under adverse conditions. Assuming there is “room” between oppressive systems and the construction of an agency-self, women may be able to contest gender expectations and enact genuine expressions of self. In this respect, Robyn Bluhm (2011) and Diana T. Meyers (1989), among others (Anderson 2008; Gammell and Stoppard 1999; Schippers 2002), argue that women have “pockets” of autonomy through which they wage meaningful challenges to their subordination and express authentic enactments of selfhood.
What is important from this perspective is how women might enter or activate such pockets of autonomy—especially given the institutional salience of oppressive forms of femininity. Here, one must consider Dana C. Jack’s (1991:138) “silencing of self” theorem in which women silence their feelings “for fear of isolation or reprisal if they express themselves truthfully in relationship.” By suppressing their authentic voice or “hiding the self” in favor of meeting familial or spousal expectations, women unintentionally reinforce patriarchal hierarchy in these relationships. While the rumination that is believed to underpin melancholy may be genuine, the anger and frustration women feel and internalize leads to their higher risk for and higher rates of emotional distress such as depression. Consequently, one must explore the possibility of women’s situated or contextual attempts to strategically reject, reformulate, or enact their distress in unexpected ways; to clearly identify the reality of their pain and, as Jack (1991:199) states, “to question the interpretations that had formally guided their perceptions and actions.” Even if this “cognitive shift” means incurring emotional costs (e.g., shame, stigma, isolation) or ending harmful relationships, it may also mean beginning or expanding upon relationships that are safe, rewarding, and emotionally healthy.
For example, feminist research on friendship has held such relationships to be supportive of nonpatriarchal relations and less gendered self-conceptions (Green 1998; O’Connor 1998). The safety of what Sara Evans and Harry Boyte (1986) called “free spaces” is characteristic of how friendships can support authentic expression and healing (see also Green 1998; Jack 1991). As Lillian Rubin (1985:10, 165–69) has argued, through same-sex friendships, women are less likely to reinforce male power relations and hegemonic femininity—an exception to this being different-sex friendships between heterosexual women and gay men. And while some research addresses friendships among older women (Jacobs 1990; Lewittes 1989; Roberto 1996; Wearing 1995), little is said about friendships for those whose emotional distress challenges the self.
Likewise, the relationship of religion to women’s self-formation, gender roles, and patriarchal systems is as complex as it is deeply embedded in their lives across history and religious creed. Linda Woodhead (2013) theorizes on how gender and religion intersect to either reinforce or challenge structures of power in society. Of particular relevance is her analysis of a “tactical trajectory within religion” (Woodhead 2013:66–67) whereby an alternative feminine self may prosper even under patriarchal structures and mainstream religions that support hegemonic femininities. Similarly, Brendan Ozawa-de Silva (2014:256–63) cogently addresses the mental health benefits of religion and spirituality, especially the social connection that fosters compassion. These relationships may help reveal the self-exploitation and harm that women shoulder as part of being virtuous caregivers (hegemonic femininity) and foster the “cognitive shift” that underlies Jack’s authentic self (resistant femininity).
Intersectional Complications
Since Brown and Harris’ (1978) classic study of depression among women, scholars have accounted for mental health disparities in terms of the stressful life conditions facing disadvantaged classes; working-class and poor women simply have fewer economic, social, and cultural resources with which to confront their depression. Contrary to middle-class women, as Beverley Skeggs (1997:162) has argued, working-class women “do not produce themselves in relation to individualistic narratives. They feel their lives are very public, very social and hence open to scrutiny.” Likewise, their enactment of femininity also incurs distinct class-based challenges that may narrow any pockets of autonomy through which they might, as Mimi Schippers (2002:37) argues, “maneuver” or negotiate the rules and meanings of gender relations. For instance, research spanning the classic studies by Herbert Gans ([1962] 1982), Carol Stack (1974), and Lillian Rubin (1976) to Annette Lareau (2011) have documented the limited (often kin oriented) friendship networks characterizing working-class families (and more so for working-class women). While social class may restrict women’s paths to friendship, Karen Walker (1995:294) finds that even for “the middle class, times of trouble are times when friendship, whose focus is shared interests and leisure, may not survive.” Despite Walker’s distinction between a middle-class emphasis on intellectual and leisure sharing compared with the working-class focus on material sharing, for women suffering emotional distress, middle-class friendships may also fall short of supporting alternative femininities.
Similarly, any gender maneuvering that is possible for emotionally distressed working-class women operates within ethnic communities and culturally informed notions of womanhood. Tamara Beauboeuf-Lafontant (2007) and Rosa Maria Gil (1996) argue that culturally specific expectations placed on minority women influence sense-making of emotional suffering as well as their differential levels of risk for depression. For example, Latinas face strong familial norms via “marianismo” (Stevens and Pescatello 1973), though working-class women (such as those in my study) may find such an ideal somewhat distant from their lives and understanding of femininity (Gil and Vasquez 1996). However, in advancing Jack’s silencing theorem, Beauboeuf-Lafontant (2007) argues that a “discourse of strength” stereotypes Black women in ways that mask their depression experiences, and insofar as this discourse is internalized, it enhances their risk of depression. For working-class African American women, there may be various ways of grappling with the discourses of strength and caretaking that either mask or transcend depression. As Beauboeuf-Lafontant (2008:402) notes, only voices that “acknowledge vulnerability” may realize an authentic self in contrast to hegemonic femininity. Here, the confluence of class and ethnicity complicates and hinders some women’s struggle to forge an alternative femininity. However, might this class, ethnicity, and gender intersection form differently among the elderly?
There have been few efforts within feminist scholarship to examine how femininities are constructed in relation to emotional distress in older age (but see Garner and Mercer 2001; Gibson 1996; Moen 2001). Elderly women living with emotional suffering such as depression confront distinct challenges in upholding a hegemonic feminine self, much less a dignified femininity. My analysis of a group of emotionally distressed elderly women seeks to theorize femininity beyond the hegemonic (e.g., “complicit and compliant”) and relative autonomy (e.g., “bitchy or silent”) models. While these perspectives may explain how women grapple with gender within a patriarchal order, they may not adequately clarify how elderly women make sense of depression and construct an alternative feminine self at the twilight of life.
Aging constitutes a situational, yet unfolding, threat to one’s self-concept given the gradual incurring of physical and social losses. These “sociobiographical disruptions” of status, roles, and body frame the ongoing (re)formulation of gendered selves (Bury 1982; Charmaz 1991; Clarke et al. 2011; Hurd 1999; Moen 2001; Thoits 2013). Such disruptions are embedded in oppressive gendered relations that differentially impact older women (Calasanti and Slevin 2001) who often experience feeling inadequate, lacking control, and being a burden to family and friends (Annandale and Hunt 1990). Some research has focused on the aging of women’s bodies as underlying personal experiences of devaluation and the reproduction of cultural discourses of beauty, productivity, fitness, and healthiness (Paulson and Willig 2008; Ray 1996). Feminist scholars such as Julia Twigg (2004) have argued that while postmodern discourses portray “ageless,” “malleable,” and “active” bodies in older age, in fact bodies and subjective experiences of them remain constrained and managed in institutional settings where body work occurs within gendered and aged power relations (see also Biggs 2004). However, this research has yet to fully explore the relationship between aging, gendered—feminine—bodies and the subjectivity of emotional distress, including rejecting the label or diagnosis of depression. As Twigg (2004:67) insists, we must . . . reassert subjectivity in relation to the body. We need a much stronger emphasis on how older people, especially frail older people, experience embodiment. The body is clearly central to old age, and we need to know more about how people feel about this, what constructions and understandings they bring to bear on it.
My interviews of elderly women allow us to hear how a feminine self is negotiated discursively through their narratives of aging and emotional distress. Specifically, I use the phrase “retreat of the body” to emphasize how the aging body is about not only physical decline but also opportunities for agency; how the aging body is not only a physical process but a symbolically negotiated experience. When the physical body can no longer fulfill role obligations as in the past, new role sets may emerge through which the self is transformed. In other words, a body in retreat may, under different circumstances, advance again through supportive relationships. In this context, I wish not only to address how class and ethnicity/race intersect in women’s effort to find authentic self but also to explore how aging impacts this intersection. Because my sample is overwhelmingly working class, their narratives illuminate the class-based obstacles facing elderly distressed women, but they can also be distinguished against how other research has depicted their middle-class counterparts (see, for example, Lareau 2011; Reay 2005; Rubin 1976; Skeggs 1997). After describing what women identify as sources of emotional distress, I discuss their experiences as characterized by feelings of shame and loss of control. I then consider how they seek to redefine the self—some through rejecting hegemonic femininity within their families, while some pursue an alternative femininity outside family relations.
Methods
This is a cross-sectional, qualitative study of 45 elderly women (15 Latina, 15 Caucasian, and 15 African American) with symptoms of depression that were identified in primary care settings in northern central California from 2012 to 2013. I selected a purposive nonprobability sample of women between the ages of 65 and 80 years with recent (within the past year) depressive symptoms and/or having received treatment for depression (e.g., antidepressants, psychotherapy). All women were screened face-to-face by the author and a research assistant who was trained in the study’s protocol and procedures and who was bilingual (Spanish). Shortly after their appointment with their primary care provider, women were approached and asked whether they were interested in being screened for the study. If they agreed, they provided written informed consent and received a gift card as a form of reimbursement for their participation in the screening. The screening protocol was constructed to select women who met sociodemographic criteria (e.g., age, race, ethnic background). Likewise, the screening procedure was also intended to identify women who were not cognitively impaired (did not show signs of dementia or memory problems), had experienced in the past year symptoms typically associated in medical psychiatric practice with emotional distress and low mood (e.g., depression), and those who reported having received usual treatment for depression in the form of medications (antidepressants), psychotherapy, or a combination of both. Women were screened for clinical depression (i.e., either major depressive disorder or dysthymia) and prior depression treatment using a two-step process. First, women were administered a modified version of the Patient Health Questionnaire (PHQ-2) (Arroll et al. 2010; Löwe, Kroenke, and Gräfe 2005), and a question on past-year depression care use (i.e., “in the past 12 months, have you had any treatment such as medications or counseling for stress, depression, or problems with sleep, appetite, or energy?”) as part of the prescreening process. Second, women who prescreened positive were further assessed by completing the Personal Health Questionnaire (PHQ-9), which has been previously validated in both English and Spanish (Huang et al. 2006; Merz et al. 2011; Phelan et al. 2010). Those who met all the criteria (i.e., age, race/ethnicity, depression symptoms and/or depression treatment, not cognitively impaired) based on this self-reported information were invited to participate in an in-depth semistructured interview at a different time in either the clinic or their home based on participant preference. The study was reviewed and approved by two separate institutional review boards, one at the author’s academic institution and the other at the medical institution where participant recruitment took place.
Data Collection
In-depth interviews were conducted in a span of one to three weeks after the screening to complete this portion of the study. At the time of the interview, each participant completed formal written consent and was given another gift card for their participation. The interviews ranged between 1.5 and 3 hours, and they were digitally audiotaped. The semistructured interview sought to explore with each woman in as much depth as possible their backgrounds, conceptions of femininity and aging, their physical and mental health, depression experience and views of depression treatment, social support, and relationship with their healthcare providers. To this end, an interview guide was organized around three main thematic domains: (1) older women’s sociodemographic and health backgrounds, ethnic and racial group membership, and conceptions of femininity and aging, (2) older women’s depression explanatory models and illness meanings, social supports and involvement in illness management, coping behaviors for depressive symptoms, and preference for involvement of kin/nonkin in depression care, and (3) older women’s views of and preferences for formal depression treatment, primary care physician and health providers’ roles in depression care, and views of how depression care in primary care can be improved. Some of the interviews with Latina participants were conducted in Spanish by the author whose native language is Spanish. All interviews were transcribed verbatim (those in Spanish were first transcribed verbatim and then translated into English) by a professional transcriber and then reviewed by the author for quality and de-identification purposes.
Data Analysis
Data analysis followed a grounded, social constructionist approach to identify main analytical categories and their relationships (Charmaz 2008; Charmaz and Belgrave 2012; Corbin and Strauss 2015). The analytic process leading to the findings presented in this paper took place in three phases that started with open coding and moved to finer degrees of coding following a constant comparison method (Glaser and Strauss 1967). Of equal importance, the initial open coding and second phase of more refined coding were conducted by the author and a trained research assistant to ensure trustworthiness, while the final more refined and interpretative phase of the coding was performed by the author only. In an initial open-coding phase, the author and research assistant independently read interviews and discussed them to achieve consensus regarding the major topical categories present in the transcripts, which included conceptions of femininity, emotional distress, family, aging, substance use, suicide, coping and help-seeking, and relationships with healthcare providers. These topical categories comprised a formal code book with definitions and examples to ensure consistency throughout the analytical process. During an extensive second phase, the author and the research assistant independently and systematically recoded all 45 interviews for these major topical categories utilizing this code book yet keeping attentive to emergent themes as is expected in the qualitative analytic tradition. The team followed this procedure until all interviews were fully coded independently, discussed collectively, and corrections were made based on consensus. Once this was completed, the author and the research assistant conducted further analyses of interviews with a focus on the material coded under the topical category of emotional distress, femininity, and coping to identify subthemes (e.g., what causes emotional distress, who helps, what makes a “woman”) and the patterns across interviews regarding these subcategories. These subthemes were also integrated into the code book so that all coding could be rechecked by the team. In a final quality check during this second phase, the author and research assistant systematically coded every fifth interview for the purpose of ensuring consistency of the coding. If discrepancies were identified, the team then reviewed the material collectively to resolve them. In a final phase, the author conducted several fine-grained analyses of interviews to identify the relationship among the themes and subthemes regarding women’s experiences of depressive symptoms, its consequences for the self, and their reported behavior in the context of those consequences. The findings presented below are the outcome of an iterative process in which the author refined the interpretation of the analysis over the course of an extended period of time. NVivo 9.0 qualitative software was used throughout the analysis process for ease of data management, open and refined coding, and cross-checking and comparing coding across the data.
Sample Sociodemographic
Of the 15 Latina participants, one was born in Puerto Rico and another in El Salvador, while the rest reported Mexican heritage (hence I use the more inclusive term Latina rather than Mexican American). One Latina and one African American woman reported having one Native American parent, and one African American was born in the U.S. Virgin Islands. Although I sought socioeconomic diversity among my sample, the recruitment process and screening protocol resulted in a predominantly working-class group based on survey questions asking for income, education, and occupational history. A majority (60 percent) reported incomes of less than $25,000, and another 20 percent reported earning between $25,000 and $50,000. Of the six women reporting the highest income levels ($50,000 and up), three Caucasians were still married as was the one Latina. The one African American woman reporting income of between $50,000 and $75,000 had a savings/retirement account. The one Caucasian woman reporting the highest income (over $100,000) had only graduated high school with a GED. In general, over half (58 percent) of my sample had only graduated from high school, with another 27 percent having attended some college. Caucasian women reported the most education (four college graduates and one master’s degree), with only two African American women and no Latinas being college graduates. Finally, the majority of occupations reported ranged from field work, to domestic/care work, to lower level retail/sales and food service work. Although some women reported occupations resembling those of the middle class (i.e., legislative consultant, artist, paralegal), the vast majority did not. Consequently, when combining income and education with occupation, only three or four women could arguably be designated as members of the professional or middle class. Given this underrepresentation of middle-class women, reasonable class comparisons within my sample are not possible. Instead, I frame such class distinctions alongside the theoretical and empirical literature to highlight the experiences of working-class elderly women.
Findings
Sources of Emotional Distress
Typically, women spoke of their emotional distress in the context of three factors: aging (“getting old and sick”), economic deprivation (“not having enough money”), and patriarchy (“being abused”). In the context of aging, 41 out of the 45 women dwelled upon their physical decline—physical illness or conditions being the primary or sole reason they see a primary care physician or specialist. Although episodic in their youth, physical pain had become chronic as they aged and was central to their accounts of emotional suffering. The words of an African American woman echoed those of other women with multiple physical ailments: I’ve got severe arthritis in my right leg, which is crippling me. I’m lonely, I’m bored, and I’m scared . . . and that’s usually because I’m in physical pain. It’s everything, the change in my body that is depressing. I guess I can use that word “depressing” because there’s too much going on at one time. The heart, the arthritis, the eyes . . . and I can’t seem to get things under control.
Beyond the physical indignity of aging, 38 of the 45 women also spoke of the impact of financial constraints on their emotional suffering, both in older age as income streams dwindled or throughout their lives. As previously noted, the vast majority had grown up in poor or working-class families. As a Caucasian woman explained, I was on medication for this, and this was all working okay other than the fact that when you’re on Medicare, the old thing with the donut hole. So all of a sudden, I am going to be paying $1,700 per month. I don’t have a job. How am I going to afford that?!
If making ends meet was hard, so too was fulfilling what many considered their financial responsibilities toward others (e.g., children, siblings). A Latina confided, [My sister has] got a bad heart and had to go in for pacemaker. She has one of those bags connected to her and [I] try to help her. [I] haven’t been able to save any money because I only have just a little over $800 a month to live on. Then there’s the household stuff. Like last month I didn’t even have the money to buy myself some Ibuprofen and a couple of snacks. It all was gone.
Finally, 42 of the 45 women described harrowing physical and emotional abuse that haunts them to this day. For some, such trauma dated back to childhood, while for others, it unfolded later in life. As one African American woman shared, I was raped when I was seven years old, and I was raped again when I was an adolescent. I never told anyone about that. I didn’t even tell myself until I was 30. I carry that with me and look how old I am now, I am sad and feel guilty and all that and still I’m blamed for what has happened to me.
A Caucasian woman remembered, The depression started after the accident when I found out my husband was cheating on me. And, I didn’t get any help for it. I just finally said—well, see, he brow-beat me and had me so insecure that I didn’t even know how to do anything. I couldn’t put dinner together. I had to be told what to cook … just made me feel like shit, down and worthless.
Similarly, as a Latina recalled, [I] got beat up for 15 years. I didn’t know what to do. I always thought you got married and had a white picket fence, and it was good . . . I knew 14 women he messed around with, besides two of my sisters. And anyway, 15 years he used to play Russian roulette, choked me until I’d pass out . . . He used to put his feet on the gas and step on it and say “I think it’s time to go to heaven with your mom.” He was Judge and God. Who wouldn’t be messed up after going through something like that; talk about breaking you and feel[ing] down in the dumps.
The physical decline of aging deepens the wounds of class and patriarchy. These women feel they are losing control of their world (if they ever had any) and the life stretching before them. Expressions such as “I don’t know what to do” or “I can’t do anything anymore” highlight this sense of helplessness. This malaise is acute for working-class women given their minimal options to express self, which has been primarily through their productive role in the domestic sphere. Although the vast majority of women worked at one time in their lives, except for a few their employment experiences in the labor market paled in comparison with their narratives of domestic life. And though ethnic/racial discrimination was occasionally noted in women’s life narratives, it did not enter into how they spoke of their emotional distress.
Shame via Hegemonic Femininity
Feminine selves in older age remain intricately tied to being useful bodies in the service of others, even of younger women such as daughters, granddaughters, or siblings. Consequently, the retreat of the body most often accentuates these women’s emotional distress. Their narratives reveal a feminine self stranded upon an emotional landscape where meaningful status conferring roles as “helpers,” “caregivers,” and “doers” recede from view. This is especially pronounced for the working-class women I interviewed whose (valued) productive role rarely extended beyond the home and family. As one African American woman put it, You feel worthless because you can’t do what you used to do when you were like 30, 40, do things to help with kids . . . I can’t no more. Even 65, 70, I was like, whew, I’d cook and the whole neighborhood would come and eat. And like, “oh, let’s go to grandma’s house, she’s always got food.” I don’t even have food anymore. I can’t handle it like I used to, so . . . you just go like “who are you anymore?” (emphasis added)
Unable to uphold hegemonic feminine expectations, many women also felt vulnerable to the “gaze of youth” around them (Twigg 2004:65). A Latina confided, “I can’t do it anymore and things get worse with them [family and friends] . . . they see me now like this . . . how can I let them see this.” A Caucasian woman’s words are also illustrative: It’s like death is coming . . . Oh, people are going to have to take care of me. I won’t be able to do what I’m doing now. Now I’m in too much pain to go on a walk. What am I going to do?! Everyone will see me like [that] . . .
Listening to these women, one could not help notice the shame engulfing them—a feeling beyond regret that often expressed their fear of losing face in the eyes of others (Scheff 2001). “I don’t want to be a pain in the ass to nobody, nobody” mused another Caucasian woman staring out the window. “I used to be the one to help and now I can’t deal with things that come my way . . . [I’m] worthless, I can’t do what I used to do.” For these working-class women who once cared for others, they were now disgraced by the prospect of becoming the object of others’ caregiving. This highlights their sense of losing control over their lives (see also Twigg 2004:64–67) and underscores the stigmatizing process afflicting the feminine self as the body retreats. The shame these women felt was further compounded by the emotional costs associated with the “hidden injuries of class” (Reay 2005; Sennett and Cobb 1972). These women had involuntarily relinquished the “badges of ability” (and fragile dignity and respect) associated with their (domestic) productive self. A self once enmeshed in working-class familial bonds was now visibly disabled, conflicted, and humbled.
The Path of Pariah Femininity
But if narratives of loss evoked shame, some women sought to redefine the self through rejecting hegemonic femininity. These women resisted expectations of “hosting and being there,” “looking presentable,” or being “at everyone’s beck and call.” Redefining the self involved controlling their time, rescinding familial obligations, and expressing their emotional distress in ways they had previously silenced. Embracing a self that “takes charge,” “demands” recognition, or “expects” respect represented a narrative twist whereby women sought control of their lives. The shame these women endured was eased through making seemingly “selfish” decisions (as one woman stated, “me first”), letting go of physical appearance (e.g., becoming a “couch potato,” “not wearing a bra”), and openly expressing discontent and despondency. Having found her voice, one Latina told me, Respect the fact that I know where the pain is and my feelings. Don’t tell me, and don’t try to over-talk me . . . It’s an insult. That is very depressing. I’m going to use another word, frustrating. That is very frustrating when you have people that under-estimate or think you’re pretending or lying, or whatever, about your pain or anything else . . . I’m done with that . . . I know what I know and you have to respect that.
Unlike when women engage in “self-silencing” to meet expectations of femininity (Jack 1991; Schreiber 1996), some women expressed their suffering and questioned family relationships they had long endured (also see Chodorow 2001). Yet when they spoke of feeling disapproval of this assertive and independent self, women approached an emotional crossroads. In this context, 43 of the 45 women spoke of conflicts and tensions with family. An African American described her situation: Sometimes I feel like I need my space. If I want to cry, I’ll cry if I want to, and nobody has to see me do it but I am not afraid to do that now. If they don’t wanna see me, they don’t have to. If I’m ill and I don’t want to have a bra on, and I’m laying down, and they [family] come over and I don’t want to come out, then I’ll just stay in my room. Now they give me my space, yeah, they know that now . . . but sometimes it’s like [my family thinks] “she is kinda b[itchy].”
If for these women their shame had abated, it came through a pariah femininity—those characteristics that threatened the accepted masculine-feminine binary. Mimi Schippers (2007:95) defines “pariah femininities” as “the quality content of hegemonic masculinity enacted by women . . . authority (bitch), being physically violent (“badass” girl), taking charge and not being compliant . . . ” They had become “inaccessible” to others and “aggressive” about defending who they wanted to be in undesirable ways (e.g., “bitchy”). Looking me straight in the eyes, a Latina said, And this sounds, at my age, with all the roads, and all the ups and downs in my life, I made up my mind that Prozac and my emotions are not going to rule me! I have to rule myself. It’s taken me this long. I’m not bad. I wasn’t bad. I wasn’t out there whoring around but that’s how I felt; that is how I’ve felt all my life. I think I’m finally able to let go of that garbage, the guilt that I shouldn’t have really been carrying all these years. The realization that I’ve taken all the blame for my mistakes, and now [it] is time to stop and [let] others do what they have to do for them[selves] . . .
Exhibiting what Schippers (2002:95) refers to as the “socially contaminating” characteristics of pariah femininity was bittersweet for these women. With a dignified self still beyond reach, such a pariah status seemed to diminish any emotional returns they might enjoy in place of a shamed self (see also Lafrance and Stoppard 2006). One might say their gender maneuvering (Schippers 2002:37) was “partial” given the overarching patriarchal heterosexual kin order of their working-class lives. Although a few women spoke lovingly of their husbands, the majority of women characterized them as abusive, unfaithful, controlling, or at best, indifferent to their needs. And while most women shared stories of their children and grandchildren that warmed the heart, their narratives sounded a familiar refrain; as children aged, they either lived too far away to visit or they were “busy with their families.” If a special son, daughter, or grandchild did assume some routine caretaking role, it often conflicted with a pariah femininity that longed for independence.
Herein rests a catch-twenty-two facing the elderly women in this study. Contrary to middle-class women whose cultural and social capital may offer femininity options, working-class women may find only pariah femininity if they redefine the self through previous or ongoing familial relationships (also see Skeggs 1997:161). With the average age of these women being 70, their lives spanned a period of gender role transformation that may have opened more identity options but not necessarily refuge from patriarchal familial relations. And unlike middle-class women for whom educational and occupational paths may hold more promise for authentic self, for working-class women, such identity options might seem less feasible or even desirable in the context of their lives. (This may be truer for the Latinas in this study, only one of whom had any postsecondary education and for whom family relations were prominent.) Indeed, these women’s family histories resemble a physical and symbolic boxing match in which they suffered the brunt of the blows, from parents and siblings as much as from husbands and boyfriends. In this light, for some perhaps becoming a “bitch” was preferable to being an “old hag,” though each incurred the emotional costs of class devaluation and personal degradation (Reay 2005).
Dignity via Alternative Feminine Selves
Apart from their families, a few women spoke of drawing strength and dignity from other corners of their lives, through friendships and faith. When most women spoke of friends and faith, they did so in the context of either hegemonic or pariah femininities. But there were a few women of each ethnic/racial group for whom friends and faith offered solace from the wounds of their past and the pain of their present.
On Friendship
In my sample, few women spoke of having many (or any) friends who were significant in their lives, either due to poor health, physical immobility, or because they spent their time with family members (often grandchildren). When not with family most women preferred the company of a bed, books, hobbies, or television to friends who required emotional resources already in short supply (on the strains associated with friendships among older women, see Moremen 2008). Many women also lost friends to death or illness. And while a few women spoke of having male friendships, normally this was in the context of institutional gatherings rather than of a personal or intimate nature.
Of the 22 of 45 women who referred to adult friendships, only eight spoke of them as ongoing and offering companionship and sympathetic understanding. “[My friends] knew me well enough that it was one of those comfortable things where they like you anyway” explained one Caucasian woman. “That is what a friend is. You don’t feel like you can do anything to break it up. It’s not like a marriage, it’s a friendship.” Such relationships brought reprieve from familial expectations or the stigma of pariah femininity. Recounting her life-long abusive relationships with men, the woman above noted the counsel of her friend: But I still hadn’t learned. I was still thinking the standard of mine, as long as they [men] didn’t beat me. I went to see a girlfriend and talked to her, and she said I didn’t have to get married. I could back out. I didn’t owe him that I had to do that, but I thought I did once. Everybody needs a friend; you can be [yourself]. (emphasis added)
Another Caucasian woman also revealed how friendships supported a more dignified self: I know those [friendships] are precious. As you get older, friends are very precious . . . having like just little casual get-togethers with older women . . . Helping older women help each [other], there’s scripture about that, isn’t there? [Friends] helping them understand that the things they are interpreting as being negative, that aren’t that negative, and to see how somebody says “I lived through it.”
One African American woman spoke of her “prayer partner” she met through a bible study class: “We’ll talk probably about once a week. Either she calls me or I call her and we talk on the phone about whatever.”
Then I have another lady that I met at the senior center, her name is K. We usually go to the movies or we out to dinner, or do different things together. We just get on the phone about whatever is going on with either one of us, about any and everything that we have going on with us. We talk a lot.
Through such friendships, these women enacted agency under duress without social repercussions, at least as indicated in their narratives. Few if any of the women relied on their friends when they were either depressed or despondent, “I would never want to burden my friends when I’m down.” Still, underpinning these elderly friendships was a retreat of the body that negated the competition for male approval and opened a path for gender maneuvering to an alternative femininity (Schippers 2002). Similar to the depressed women who spoke with Jack (1991:199–201) about the support offered by friends “to risk being themselves and to test out new images of self in relationship,” some elderly women found a dignified self through friendships that transcended the pariah femininity of family life. Although friendships can be fragile as well as durable, draining as much as supportive, it is precisely their fluidity that made self-renewal possible. Were it not for these relationships, as so many women without friendships revealed, their depression and memories bore down upon them as they sought refuge in bed or by the television—alone.
Indeed, whereas middle-class elderly women may have access to more friendships given their social capital and past occupational connections (Fischer 1982; Lareau 2011), working-class elderly women may find it harder in their senior years to seek out or sustain relationships, much less ones that support an alternative self. Although not fully confirmed by my data, this could be more likely for the Latinas whose family life may have limited their circle of friends, than for African American women whose extended kin networks might include more valued friends. On the other hand, as Beauboeuf-Lafontant (2007:47) has noted, insofar as a “discourse of strength” has been internalized, “Black women may experience shame when divulging their depressive realities” to friends and “such networks may help women to manage their struggles rather than question their loads.” But for at least a few African American women in my study, friendships helped them “question their load.”
On Faith
As evidenced from some of the quotes about friendships, women’s narratives frequently referenced religion in coping with depression and seeking authentic self (see also Gatz and Fiske 2003; Ozawa-de Silva 2014). As references to “God,” “scripture,” “church,” and “prayer” attest, faith was significant for many women. Faith was mentioned at least in passing by 37 of the 45 women who spoke of explicit religious affiliations, references to spirituality, or a “personal relationship with God.” Notably, while eight of 15 Caucasian women mentioned faith, all African American women and all but one Latina did. Although consistent with higher rates of religious observance among these ethnic groups (Krause 2004; Krause and Bastida 2012), references to faith nonetheless reflected differing degrees of involvement and religious commitment. Furthermore, none of the women spoke of their congregation, church, or synagogue as specifically supporting progressive gender identities or reconstructions; rather, with the possible exception of prayer groups and organized activities, their narratives personalized faith experiences. And if women understandably said that faith helped them cope with “the bad times,” only a few women from each group spoke of it in terms of a transformed feminine self.
For example, after sharing her grief about a failed marriage and the deaths of her much beloved mother and son within months of each other, one Caucasian woman recalled, But at that particular time something happened to me, or I re-thought my life, and I was pulled back to my spiritual roots. [It’s] the thing that gives me my peace and my strength, and everything else. And that I didn’t have to approach life with fear anymore. I was starting to live and discovered me.
An African American woman spoke of returning to her childhood faith following a period of crisis. After her first husband killed her only son (by another father) because he had stolen drugs from him, she turned to drugs herself. For nearly a decade, she suffered from her loss and addiction. “I would drive down the freeway with my eyes closed, and I’d be doped up, see? I would overdose, see.”
And that really scared me, so I have to make a complete change. So I went to church and ain’t never looked back. The Lord is good to me. He loved me when I didn’t love myself. He loved me first, so that’s why I turned my whole life around.
Likewise, a Latina recalled when her husband abused alcohol and her, beating her physically and emotionally. How did she survive? “Praying and going to church.” As a testament to her strength of character as much as her faith, she stayed with her husband until he followed her path.
Finally, I mean after he changed, after he went to church, and I recognized who I was, and I valued myself, not through his eyes. But I learned to see myself through God’s eyes, that I was just as important, because women have a tendency to value theirselves or see themselves the way the men in their life see them. If they don’t appreciate them or value them, the woman doesn’t, you tend to believe, you know, he said “I’m this or that, so I guess I am, you know.”
As she spoke of valuing herself “not through his eyes” but through God’s eyes, this woman also came to value herself through her eyes: “But during those ten years, I wasn’t that dumb 16-year-old girl that he met. I changed, and he, uh, he didn’t know how to cope with that either.” Whether it was the institutionalized support of church members or an opaque sense of personal spirituality, religious faith might temper a history of abuse and depression even as it obscured the hegemonic femininity that confined them. But for a few women, their spirituality proved liberating from the tragedies of life and nurtured an alternative feminine self that others found difficult “to cope with.”
The relationship of religion to class and ethnicity is complicated, especially its reinforcing or transforming influence on gender identity. Although my data do not unravel this complexity, for women finding an alternative self through faith, it may be due less to their spiritual beliefs per se than the social connections their religious observance reinforced (Maselko, Hughes, and Cheney 2011), something that was of short supply in their working-class lives. For instance, as one African American woman quoted earlier recalled, You know, I was going to say, we do Bible studies at my class on different subjects, and we had a lady’s Bible study. The topic was women who walk alone. And there was a book, I forget the lady’s name that wrote the book that we were using, but there were about 30, 40 ladies in this class. They had us pair off as partners, and the lady that I paired off partners with–and this has been about three years ago–we still talk.
Even though religious organizations and faith did not routinely support an alternative self, Woodhead’s (2013:68) theory of gender and religion suggests that we keep in mind how “women are more likely to seek the personal and emotional benefits which derive from the supportive relationships they forge in ecclesiastical contexts.” Such supportive faith-based relationships may present opportunities for gender maneuvering (Schippers 2002) that circumvented family expectations or challenged them outright. Perhaps religion may serve working-class women in a manner similar to how secular higher education serves middle-class women—as a space for personal development and growth.
Conclusion
Femininity and class intersect poignantly in how the elderly women in this study confront aging and emotional distress. On one hand, with aging came a retreat of the productive body whereby redefining the self meant curbing relationships and rescinding material and social obligations toward family. Yet those women who resisted hegemonic femininity were spurned by families who frequently stigmatized and devalued them to a pariah status (see also Lafrance and Stoppard 2006). Here, social class impeded their struggle insofar as their gender identities were wedged within working-class familial relations. Furthermore, as Schippers’ (2007:99) theorizing suggests, though working-class ethnic/raced women may similarly enact hegemonic feminine qualities of domestic labor and caring, their incapacity to continue fulfilling this role may reinforce their class and ethnic/race devaluation more than their subordinate gender status. Diane Reay’s (2005) analysis of emotional capital extends this observation if one allows that relative to middle-class women, working-class women have meager emotional reserves in dealing with aging and depression. Given the challenges of expanding their social connections and their rejection of professional therapy, only the hardiest elderly women can avoid maneuvering toward a pariah status. Then again, a few women viewed a retreating productive body as nullifying familial and spousal claims to them. Through friendships or faith, they found precious social space within which to cultivate an alternative feminine self that was understood, accepted, and nurtured—a self not held to hegemonic standards nor debased by the limitations and desires of aging. Keep in mind that friendship or faith did not guarantee women a path toward gender dignity and integrity, but rather they opened the possibility of redefining the self through symbolic resources unavailable or inactive in the family unit. Much like female friendships, as Woodhead (2013:68) notes, “tactical religion carves out and flourishes in women-only spaces which gain the protection of male-dominated religion, but escape its immediate supervision.” In this respect, future research should seek a more equitable sample of middle- and working-class women to systematically explore some of the contrasts I propose and how the retreat of the body is comparatively experienced in class ways.
Although I began this study expecting to find clearer ethnic/racial variation in how women spoke about aging and depression, hardly any surfaced in their narratives. While more research should focus on racial/ethnic differences among elderly women with symptoms of depression, consistent with other literature (Mio and Iwamasa 2003), I think that though prejudice or discrimination was not given as a reason for their emotional distress, ethnic cultural heritage may still play some part in shaping their experience of it vis-à-vis the feminine self. For instance, to the degree that working-class Latinas and African American women live within the margins of hegemonic femininity and mainstream religious theologies, those who exhibit what Jack (1991:196) calls a “moral order of meaning” are even more notable within their class/ethnic subcultures. The issue may lie in how hard individual working-class Latinas must negotiate with an ethnic heritage emphasizing family to achieve authentic self, and whether individual working-class African American women can redefine the silencing discourse of strength that lives on through their community and conventional stereotypes. Indeed, I heard no references to what critical race theorists describe as a “community cultural wealth” that might collectively support an alternative feminine self (see Yosso 2006). Although ethnicity and race still resonate in their lives, their narratives of emotional distress and depression highlight their roles as elderly women (Stoppard and McMullen 2003) whereby the retreat of the body may correspond to a receding of ethnic/racial signifiers of a (past) feminine self.
For instance, while ten of the African American women either preferred or were fine with family members attending doctor appointments and helping with their medical care, only four Caucasian women were and, surprisingly given popular conceptions of the importance of family among Latinx, only six of the Latinas were (with three needing them only as interpreters). Most of the women expressed wanting their independence, not “burdening” or “worrying” their families, or not enduring the conflicts associated with family care. In the case of Latinas, though they never expressed it, they may have harbored concerns about their children’s ability to take time off from work and employer repercussions given fears of ethnic discrimination and prejudice. Here is where medical visits or treatment options for either physical conditions or emotional distress (including depression) might be sensitive to family-alternative options (such as home care workers) that preserve a degree of autonomy but also provide less encumbered space for a dignified feminine self to develop. Similarly, health providers could be more alert to changing family roles and stressors (whether they are personal or time-related conflicts) that may inhibit elderly women from fully disclosing their physical and emotional struggles. Although they might still be mothers (and grandmothers), their role set with descendants may likely be more distant and compromised than in their youth.
Last, where the literature on the social origins of depression focuses on loss, whether of self or the social relations constituting it, a feminist contribution to this perspective must focus on a specific form of loss—the loss of control. Losing a self with little control over one’s life is hardly a loss as long as one enters social relations that nurture a self with far more control. And as aging signals a retreat of the body, I have argued this could be as much an opportunity as a loss. If for Marxist theory, a key to working-class liberation is their ability to control their labor (see, for example, Edwards 1979), then for feminist theory, it must be how working-class women control their gender roles (see, for example, Lorber 1994; Skeggs 1997). In summary, narratives of losing a hegemonic self center on shame without control, while narratives of emerging pariah femininity emphasize control with emotional costs. But narratives of a feminine self embedded in friendship or faith raise the prospect of control with dignity. One key limitation of my study that should guide future research is the how the intersection of class and race with emotional distress among elderly women operates among lesbian, bisexual, or transgendered populations. Although I did not screen for or ask specifically about these identities, neither did any of the women I interviewed raise the issue either directly or indirectly (though a few women did mention children or relatives who identified as such). Here, the question of control with dignity is even more pronounced, but in the context perhaps of a different family history and, as Rubin (1985:165–69) noted above, different friendship relations that likely affect gender maneuvering.
Might depressed elderly women who reformulate a feminine self better confront their suffering and find improved quality of life? What would it mean in their roles as wives, mothers, grandmothers, friends, community members? Social research on depression among women has emphasized the importance of changing role sets and social relationships as both a pathway to and treatment for emotional distress such as depression (Cruikshank 2013; George 2011). Although attention is more commonly placed on how spouses and/or family might support elderly women with depression, there is less concern with how these relationships may actually foster depression and distance from authentic self. Certainly as the self of elderly women is transformed in so many ways (Garner and Mercer 2001), so too must their social milieu adapt to them. All of which points to the dilemma of humane connection as women age. As Jack (1991:191) puts it, “depression seems inevitable when a woman abandons hope of authentic connection, or when she can imagine only two possibilities for her future: subordination or isolation, holding a form of loss on either side.” The subordination of a hegemonic self and the isolation of a pariah self can be evaded through a self in which “intimacy can only occur through a dialogue between other and self within which the ‘I’ is present (191).” In my interviews, it is in references to friendships or faith that one senses an “I” that is present for some women. It is here where they sought hope and serenity. An alternative self may “cut the edge” of older women’s suffering and provide the emotional resources to change their inner world, even if the outer world stretches beyond their control.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
