Joumal of Advanced Nursmg, 1992,17,1334-1342
Mothers and daughters: a powerful spell Chnstine Webb BA MSc PhD SRN RSCN RNT Professor, Department of Nursing, The Universtty, Manchester Ml3 9PT, England
Accepted for publjcahon 30 March 1992
WEBB C (1992) Journal of Advanced Nursmg 1 7 , 1 3 3 4 - I 3 4 2 Mothers and daughters: a powerful spell An unantiapated findmg of a small exploratory study of the health of nevermamed women m old age is discussed Focused conversational interviews yielded evidence of the potent effect the mother-daughter relationship had in a group of women who had lived for all their adult lives in the parental home Usually mothers had outlived fathers, and v*^hen they finally died daughters lost someone to whom they had been very close and at the same time had to cope v>^ith living alone for the first tune in their lives Three case histones, illustrating both strong positive and negative aspects of mother-daughter relationships are reported, and the psychological and sociological literature is explored Parallels are also drawn with biographical and autobiographical literature about this type of relationship, including that of Florence Nightingale and her mother Fmally, some implications for nurses are considered and the special support needs of these women at bereavement and m old age are highlighted INTRODUCTION
eamers (because on average women eam less than men).
Oh, what a power is motherhood, possessmg a potent spell ^^ ^'^''^^ ^o^^e" ^^"^ to work in jobs where pension (Iphigenia m Aulis, Eunpides 405 BC) schemes are less available than m professional-type jobs (Peace 1986) In addition, it seemed likely that the support resources of never-mamed women would be restncted This quotahon sums up an unantiapated theme that because they had no family of mamage and no offspnng to emerged very strongly from a study of the health of never- offer them assistance m old age mamed women m old age, that is the powerful influence on these women of their relahonships with their mothers I became mterested m studying this group of women after My future discovermg that the bterature on women's health rarely mentioned speafically those who had never mamed A further reason for being interested m this group of Where 'smgle' women's health was discussed, reports women is that I am m the same category, and as middle age usually mduded the never-mamed, widowed, divorced approaches I am begmnmg to consider what my future will and separated withm one category The few studies of be like Cnhcs of the feminist movement have noted that never-mamed women were mostly Amencan, which raises hitherto the emphasis m feminist wntmgs has been on queshons about their appbcabibty to the Bntish culture and younger women and on issues related to reprodudion It to our different health care system is only as modem feminists ourselves age that we are It seemed likely that never-mamed women might have beginnmg to tum our attention to issues confrontmg older had different health expenences and needs, because they women (see, for example, Macdonald & Rich 1984, Creer might have acted as Ccirers to elderly parents, peiiiaps 1991) givCTi up work to do this, and therefore were likely to have In this paper I shall descnbe the research methodology bimted fmanaal resources Even if they had had a contmu- and give some biographical information about the women ous work history, they were likely to have been low studied The mam focus will then be on three case histones 1334
Mothers and daughters
that feature the particularly strong relahonships between mothers and daughters, and how they affected the health and bfe courses of the women concemed After discussmg these histones in the light of available bterature, I shall dose the paper by drawmg out some lmpbcahons of the study for nurses—particularly those working m the commumty
THE STUDY Design The study was plarmed as a small exploratory and descnphve one, intended to throw more light on the relatively untapped topic of the health of never-mamed women m old age The approach I chose was that of reflexive ethnography (Hammersley & Atkmson 1983), combmed with a femimst perspedive These two are compatible because the reflexive aspect requires that the researcher gives attention throughout the study to her part m the research encounter and how she influences the data collected and their mterpretahon A femimst approach also draws attention to the fact that, espeaally when women study other women, tradihonal positivishc calls for 'objechvity' are impossible to achieve (Oakley 1981) Instead, in feminist research the researcher attempts to create as equal as possible a relationship between herself and her partiapants, to focus on issues that are important to women themselves rather thim imposing a research agenda from outside their context, and by conceptualizing the research as a means of improvmg women's bves (Russell 1987) Thus, I introduced myself to interviewees both as a nurse researcher who was particularly interested m women's health but also as a never-mamed woman who was eager to find out about their situations because they were of great personal relevance The interviews were conducted in women's homes, were tape-recorded, and lasted between 1 and 2 hours They were arranged through two general practitioners who suppbed the names of suitable women on their registers, and by wntmg to women to explain the study, mvite them to participate and, if they were willing to do so, to retum a tear-off sbp in a stamped addressed envelope On receipt of posihve replies, I contacted women by telephone or by callmg at their homes to make a daytime appointment I considered that daytime rather than evening mterviews were essential so that potential participants would not feel afraid of someone calbng when it might already be dark Also after expenence of evening interviews myself, I was arucious about my own personal safety
when trying to locate house numbers m an unfcimibar area aiier nightfall Interviews were of the focused conversahonal type, and I began by using a health history as the vehicle for gettmg women to talk about their bves and health This seemed the most natural way of approaching the subject because I had introduced myself to them as a nurse and had gained access to them via their general prachtioners I analysed the interviews concurrently so that I could identify emergmg themes and follow these up in subsequent interviews, while continuing to follow the general pattem of taking a broadly ranging health history
WOMEN'S LIFE HISTORIES Fifteen women were interviewed from two diffenng residential distncts on the outskirts of a large metropolitan area Six women bved on a lcirge out-of-town counal housing estate and the other mne were from a more affluent suburb but two of them also lived m flats rented from the local housing authonty Thus there was a broad mix m terms of sociai dass background The mean age of partiapants was 77, with the same median, and a range of 66 to 89 Six had done manual factory work before retirement, two had been office workers, three had been 'nurses' (one occupational health nurse, one midwife, and one unqualified residential nursery nurse), and three had worked m family businesses Despite their rather diverse sociai backgrounds, parhapants were similar m many ways Most notably, all but the three nurses had bved in their parentiil homes all their bves unhl the last parent—usually the mother—^had died All but one of these 12 had subsequently given up the family home and moved mto smaller accommodation All 15 women were bvmg alone at the hme of interview, and had been doing so for a number of years Whilst some had played a canng role for their parents for some penod, none had done this extensively and none had given up work to do so Only two mterviewees had any survivmg family members living dose enough to assist them if they were ill For others, support resources were sparse cmd depended on arrangements which nught well not be sufficient or robust enough if they needed mtensive or long-term assistance Most said that they would rely on a fnend of similar age or a neighbour callmg m to see them and to do shopping Several simply did not know how they would manage They were reluctemt to be admitted to hospital, somehmes because of negahve rep)orts or their own exjienences of hospitabzahon, and did not want to leave their own homes In several cases this was because of fears of burglanes, one 1335
C Webb woman bvmg on the council estate havmg been burgled three times and another four times Their reluctance to go mto hospital might also have been related to even stronger fears about going mto a home' and losmg the highly valued mdependence which had charadenzed much of their bves as never-mamed women Support from statutory services was similarly extremely limited Apart from home helps, and one womam who had meals on wheels, none was in contact with any services other than when she mitiated contact with her general practitioner for repeat prescnphons or an acute problem Only one had had the recently mstituted health screenmg visit from a prachce nurse
Precarious circumstances The group of women mterviewed seemed to be m very precanous circumstances with regard to support and assistance if they became ill, and it was easy to imagme senous implications of this situation Indeed, one partiapant had fallen and broken her collar bone some months earlier but had no telephone and had not been found until her 80-yearold brother-in-law had called m by chance the next day Having pamted a picture of the health and sociai arcumstances of the sample of women mterviewed, I shall now present three case histones to illustrate the strength of mother—daughter relationships m these women who had lived with their mothers until the latter's deaths The three case histones are chosen to illustrate both negahve and posihve relationships, and how influences from childhood can have a lastmg and pervasive effect on thinking and on daily living
CASE HISTORY 1 Miss A was 73 years old and bved m a counal flat in a block which was enhrely given over to 'pensioners' It had centred heatmg, although Miss A could not afford to use this, and relied mstead on an electnc fire I visited her m February dunng a spell of heavy snow, and after bemg there an hour I could hardly feel my fingers and toes Miss A had worked m a factory or as an outworker, domg sewmg, and was rebant on a state pension For the past few years she had been eatmg mto her small savmgs in order to pay everyday bvmg expenses After paymg the 'bills' such as electnaty and gas, she had £ 6 per week of her pension left for housekeepmg Miss A's father had died when she was 16 and for a time she and her mother had bved with her maternal grandmother Later they had moved out and bved together for 1336
another 40 years They had been very dose, 'bke sisters', and descnbmg bfe with her mother, she said She made all the deasions but I carried them out We pooled our money and we only had one purse We didn't have any 'spends', just that purse If one of us needed somethmg—say a new pair of shoes—we saved up and bought it from the purse We did the housework together Her mother had died at the age of 90 after a penod of 'going downhill' She had been mentally alert until losmg consaousness and dymg at home 2 weeks later of pneumonia Tcilkmg of her mother's death. Miss A said, I thought a lot of her It was a big blow but I knew she was slipping away Because they had lived m their counal house for many years. Miss A had 'a lot of fnends and neighbours then' who had supported her But continuing to live in the house was too much for her because her mother 'was everywhere, m all the rooms, all round the house' So she had moved to her present flat, and was pleased to have done so, although she shll thought a great deal about her mother and said, 'she could have lived here—we could have got two single beds mto the bedroom'
Contacts Since movmg to her flat. Miss A had lost touch with her former fnends and neighbours, and now only had one fiiend This was a widow, bvmg m the same block, whom she had known for 50 years and had met through her church However, this fnend had recently gone mto hospital and it seemed unbkely that she would retum to bve in her flat Miss A's only soafd contacts now were at church on Sundays Her niam pastime was watching television She had given up her weekly home-help because she could no longer afford it One thmg that had always bothered Miss A and contmued to do so was that people usually addressed her as 'Mrs A' She said, I get called Mrs A all the time and I don't bke it My mother was Mrs A but I've got weary of telling people
CASE HISTORY 2 was 84 and she had bved with her mother, agam like two sisters' from 1939 to 1967 when her mother died
MISS B
Mothers and daughters
Her father had died when she was a child and she had gone to live with her grandparents Her mother remamed but this second husband also died and Miss B had retumed to bve with her mother Mrs B had had a hysterectomy and 2 years later, aged 29, Miss B had one also and so they were able to share this and so many other expenences Miss B descnbed herself as the tenant of the accommodation she shared with her mother, but it had been her mother who had taken all the deasions Miss B accepted this because they were so dose She descnbed her mother as 'a sfrong spmt but not physically sfrong', due to a 'damaged throat from sucking a doll pamted with lead paint when she was a child' Miss B had always done the housework but her mother had done the cooking Of her mother's death she said.
dressed her mother and sat her m a chair Her mother had behaved selfishly dunng this penod, insisting that the home-help spent hme with her rather than domg the housework, so that Miss C had to do this too Her mother had been unable to walk, but Miss C was not sure why this had been and seemed to be suggesting that her mother could have been more independent if she had wanted to be When her mother had died Miss C had been very sad She had always had a chip on her shoulder My brother died when he was 6 and she turned round and said 'I wish it had been her' (Miss C) After she died I found I had been bom out of wedlock She should have told me I found out through a birth certificate Other people knew, but not me I kept thinking about hints, etc, on my father's side They more or less pushed me out I'd have liked to know I thought she could have trusted me better Sbe was a good mother, but most of it was just duty
When she died the biggest difference was not having a cooked meal ready when I came in I lacked confidence in cooking I could cook but she always told me what to do I missed her I came m and thought 'I must tell my mother that'—^but Attachment to mother sbe wasn't there She explamed how she had really only leamed to cook after her mother died, and that after a few weeks she had realized that the house was getting very untidy because nobody was tidying up and putting thmgs away as her mother had done She had to leam these basic housekeeping skills, as well as plannmg and budgeting and seeing that the bills got paid Of the financial side of things, she commented That was a bit gnm I was m a bit of a pickle when it was just my wage I just had to sweat it out—I just leamed the hard way
CASE HISTORY 3 Miss C was 81 and seemed very frail She said that she had been healthy up to the age of 60, although she had been 'delicate' as a child following rheumatic fever which had left her with mitral valve damage She had had a mastectomy 10 years earber, but her mam problem now was severe arthntis which meant that she was virtually chairbound As a child she had lived with her grandparents unhl she was 12 because her mother had been 'm service' At the age of 12 she had been sent to live m a convent school and on leaving there had been in lodgings for 4 years unhl going to bve with her mother m rented rooms She had then bved with her mother continuously until the latter's death m 1973 at the age of 89 Miss B had cared for her mother as she became older, but had contmued m paid employment She washed and
Miss C, then, bke Miss A and Miss B, had had a very strong attachment to her mother, but the relationship had not been of the same posihve quabty The long years of her mother's resentment against her because she had become pregnant with Miss C before getting mamed still weighed very heavily, and Miss C cried as she told me her story She had worked for some years in a children's nursery and said of this Some of the children I've looked after never knew their fathers—it didn't make any difference In saymg this she seemed to be expressing the fact that it should not have made any difference to the way her mother had treated her, and the fact that it had done so was still a source of great distress to her
MOTHER-DAUGHTER RELATIONS Simone de Beauvoir (1952) wntes of ambivalence m mother-daughter relahonships, descnbmg daughters as both the 'prey' and the 'double' of their mothers In de Beauvoir's view, the role of wife depnves women of their freedom but the role of mother does so even more Accordmg to Tong's mterpretation of de Beauvoir's wntmgs, pregnancy abenates a woman from herself because once encumbered with a child she is unable to control her own destiny At first the creativeness of having a child may seem to liberate a mother, but reanng a child is very demanding and tums the woman into 1337
C Webb an object, a machme for cooking, clearung, canng, giving and esp>eaally sacnfiang Reduced to an object, the mother, not unexpectedly, begms to view and to use her child as an object, as something that can make up for her deep sense of frustration (Tong 1989)
De Beauvoir (1952) believes that, m companson with sons, mother-daughter relationships are much more dramatic [The mother] projects upon her daughter all the ambiguity of her relation with herself It is between mother and daughter that the conflicts take aggravated form This view follows from de Beauvoir's conceptuabzation of women as 'other', m that men see the world in their own tenns and consider women as different and 'other' than them rather than having unique charactenstics of their own Elshtam (1981) cntiazes de Beauvoir on three counts First, her ideas do not relate directly to women's bved expenence Her wnhngs use language and concepts which are abstract and philosophical and only likely to be able to be understood by highly educated women The second cnhasm is that de Beauvoir sees the female body m negahve terms, as 'burdensome' and 'inherently alienahng' She was concemed about the way that the female body places burdens on women that are much greater than those of the male, and saw this female body as bmitmg women's freedom This distrust of the female body prevents de Beauvoir from celebrating its pleasures and capacities, and is likely to put off women who regard aspects of sexuality such as childbirth, pregnancy and breastfeeding as positive exf>enences Elshtam's (1981) third cnhasm is related to de Beauvoir's seeming acceptance of male norms By devaluing the female body she is implying an opposite acceptance of and preference for the male body and character She saw women as achievmg freedom by followmg the ways fraditionally adopted by men As Elshtam puts it To ask women to give up their female identities, without considenng the ramifications of trading m sisterhood for the universal brotherhood of mankmd, is irresponsible De Beauvoir wrote from her own perspective as a highly educated middle-class French woman Her wnhngs had great appeal and influence for similar women, who found what she wrote liberating She was concemed that women
should not be limited by their biology but should be able to 1338
determine their own existence, within the limits imposed by soaal structures (Tong 1989) Sociai processes After de Beauvoir, the most influential wnter on motherdaughter relationships is perhaps Nancy Chodorow Like other feminist wnters such as Juliet Mitchell (1974) she sought to use psychoanalyhc work to elucidate sociai processes, rather than relymg on biologically based explanations (Chodorow 1978) Chodorow (1978) believes that it is the fad that women are responsible for mothenng, and men play bttle or no part, that determines the psychological development of children and accounts for the intense emohonal bonds between girls and their mothers She recognizes that these emohonal hes can be those of anger as well as of love, or even a mixture of the two which she terms a 'double life' She claims that strong mother-daughter relationships are a re-creation of mothers' own relationships with their mothers Mothers see their daughters as less separate from themselves than their sons, and therefore form closer bonds with them, and girls always retam this early identification with their mothers This relahonship will always be stronger than the father-daughter relahonship because fathers take so bttle part m childreanng Girls' identification with their mothers leads to their greater empathy and sensitivity to others, and thus in tum their own desire to mother is almost mevitable
Mother-son Mother-son love is different, according to Chodorow (1978), because it is less 'narassistic' and is focused on someone who is different from themselves To develop a masculme ldenhty boys must separate themselves from their mothers as their early love objects and must reject their previous attachments and ldentificahon with their mothers This process leads men to feel the need to demonstrate their differentness from women, and to dommate them Chodorow's work, like that of de Beauvoir, has been very influential among femimsts It has foimed the basis of a femimst therapy movement, and particularly the work of Eichenbaum and Orbach at the London Women's Therapy Centre Their therapy focuses on the centrality of the mother-daughter relahonship, as a result of which daughters have leamed from their mothers to repress their own emohonal needs and to feel unworthy and rejected The therapeutic process aims to
Mothers and daughters
rebuild the cbent's 'sense of self and confirm that she needs and deserves to be taken care of and wiU—through the 'repair work' of therapy—begm to grow in strength and autonomy (Segal 1987)
Despite its success as a basis for therapy, a number of important cnticisms can be made of Chodorow's work She puts forward a somewhat mechamstic picture of women as all behaving the same, despite differences of social dass, race and stage in history It is as if all mothers at all stages m history and in all cultures reared their children in preasely the same way The fact that some women are mamed and others are smgle parents, financial circumstances differ greatly, women have varying levels of educahon, and a host of other factors, contnbute to multitudinous ways of reanng children and not the 'psychic essentialism' descnbed by Chodorow (Segal 1987) It IS by no means universally accepted that Chodorow's solution of dual parenting will lead to improvements for women (Tong 1989) Elshtam (1981) asks whether men will become better if they share in childreanng and women will become worse It might be that both girls and boys will benefit because boys will no longer feel the need to control women and curb their emotional side, while women will gam in authonty and power while remammg canng (Dmnerstein 1977) Elshtam considers that, by shanng parenting with men and participating to a more equal extent also in the world of work, women will take on male aggressiveness Janice Raymond (1986) is m favour of equal parenting if it leads to men becoming more nurturant and to future children being less misogymstic However, this strategy gives men the status of 'saviours', and gives them even greater power than they now have withm the family as well as outside There is so far no agreement, then, about whether the overall effects of ducd parenting would be negahve or positive for women, men, girls or boys Beyond the soaological and psychological bterature, there has also been great mterest in mother-daughter relationships in recent years Nancy Fnday's My Mother, My Self (1979) is one of a genre of books emanating from the USA Fnday's work is autobiographical, while Judith Arcana's Our Mother's Daughters (1981) is based on interviews with women Arcana descnbes her wnting of the book as
impelled by a passion to know and understand my own mother, to overcome the gnef and pain of our bond, and to strengthen the true, deep connection between us as women (Arcana 1983)
Karen Payne's (1983) edited collechon of letters between mothers and daughter is enhtled Between Ourselves, and illustrates the 'sometimes strong disapproval, even violent disagreement across the generations' but also includes mothers and daughters who have encouraged each other to go far beyond the conventional definitions of good mothers and dutiful daughters, and have given each other crucial support The phrase 'dutiful daughters' is a reminder that Simone de Beauvoir also wrote about her relationship with her mother in Memoirs of a Dutiful Daughter and A Very Easy Death (De Beauvoir 1959,1969)
Nightingale myth Closer to home, the Nightingale myth has recently been challenged by analyses of her personabty and family relationships Florence was a disappointment to her mother, Fanny, and to her elder sister, Parthenope Although reputedly a young woman of great beauty and m great demand m 'society', Florence was determined to realize her vocation as a nurse Accordmg to Payne (1983) By the age of 30 her sense of calling had not diminished m the slightest, although her mother's contmued frustration of her goal had led Florence to suffer from hallucinations, insomnia, complete disinterest in soaal life, and an acute desire to die Family fnends, the Bracebndges, were extremely womed about Florence's physical and mental health and took her abroad on several holidays On one of these tnps, Florence spent 2 weeks at the Instituhon for Deaconesses at Kaiserswerth, a rebgious hospital, but still her mother resisted her ambitions This contmued opposition by her mother and sister led Nightingale to wnte Cassandra, a pamphlet m which she expressed her anger at the thwartmg of women's 'passion, mtellect, moral achvity' She concluded that the family IS too narrow a field for the development of an immortal spirit The family uses people not for what they are, nor for what they are mtended to be, but for what it wants them for— its own uses It thinks of them not as what God has made them but as the something which it has arranged that they shall be This system dooms some minds to incurable infancy, others to silent misery (Nighhngale 1979)
After fmally succeeding m gomg to work in the Crimea, Nightingale retumed to this country and bved as an mvcilid 1339
C Webb for most of the rest of her life Her difficult relationship with her mother and sister contmued, and affeded her mental health Although her 'illness' appeared to be predominantly a physical one, it seems dear that the emohonal aspects were the underlying problem (O'Bnen & Smith 1991) Payne (1983) traces much of Nightingale's behaviour back to the mother—daughter relationship She wntes Despite the numerous danng, mtelbgent and supportive women whom she met and worked with, Florence never seemed able to overcome her feebngs of distrust, based on her relahons with Fanny and Parthe She felt that she could not rely on women and never really believed most women capable of anything other than petty domestic tyranny Her joumal entry in 1857 about 'the real fathers and mothers indicates that she did not thmk that Fanny had mothered her—certamlv not m any positive sense
DISCUSSION The case histories show that Miss A and Miss B retained throughout their bves the strong attachments and ldenhfication with their mothers descnbed by Chodorow (1978) This was true for Miss B even though she had partly been brought up by her grandparents and had bved apart from her mother for much of her childhood and teenage years Miss C had also been brought up by grandparents and then gone to a residential school Living apart from her mother for some of her formative years had similarly not diminished the strong emotional ties Miss C felt with her mother, despite a lifetime of resentment on her mother's part Her mother had continued to be 'difficult' towards Miss C even when she was canng for her in old age Their bondmg seemed to be marked by the 'gnef and pam' descnbed by Arcana (1983), or to be like the 'double life' identified by Chodorow (1978) Miss C's story parallels that of Florence Nightingale's relahonship with her mother Despite a lifehme of 'petty domestic tyranny' (Payne 1983), both women had cared for their agemg mothers as the latter's health declined despite suffenng poor health themselves The profound bonding that had taken place m the very early years for Miss B and Miss C had endured despite later childhoods m which they lived with grandparents and only saw their mothers on visits For all three women, emohonal dependence on their mothers seemed to have replaced the role that might have been taken by a spouse They revealed elements of lack of autonomy, in emotional coping and coping with activities of daily livmg which have been descnbed in relahon to widows (Lopata et al 1982) The 1340
strength of their maternal hes had cut them off from other confiding relahonships and left them soaally isolated m old age If they had not lived so closely with their mothers, they might have formed finendships and had confidantes who could have offered mutual support in old age There is a great deal of evidence, then, in both literary and saenhfic wntmgs, of the power, ambiguities and ambivalence that be behind mother-daughter relationships The case histones presented mirror what is found m the bterature and attest to the continuing very real influence of this relationship on women's bves, an influence which cames through mto their own old age
IMPLICATIONS FOR NURSES Never-mamed women are a sigmficant mmonty and form an increasmg proportion of the elderly population (OPCS 1989) The data from this study, while being collected from a small and non-representahve population, nevertheless suggest issues that are important for the care of never-marned women in old age The particular cohort studied may be among the last of what has been termed a distinct soaal type' (Rubinstein 1987) Family pattems and lower levels of geographical mobility than today meant that women who did not marry tended to remain in the parental home for most of their bves The case histones descnbed show that motherdaughter relationships retained an intensity that might have been transferred to husbands, had the women mamed It is therefore not surpnsing that mothers' deaths constituted a major bfe event for these elderly daughters, and this condusion matches that of Rubmstem (1987), who wntes Tliere exist for some [never-mamed people] deep feebngs of loss and abandonment upon the death of parents [who] were co-residents into mid- or late-bfe Theirs is not an unfelt, lossless old age, a conclusion that might be inferred from a focus on the lack of mantai bereavement Tunstall (1966) draws similar conclusions When speaking of their parents' deaths they [smgle old people] sound strangely bke widows talking about their husbands dying The majonty have continued to live with their parents It is hardly surpnsing that a single woman should have been especially devoted to a parent [usually a mother] with whom she had bved for forty-three years Given, further, that the death of this second parent often left the single person bving alone for the first time in her life the second parental death becomes a uruque watershed m the single person's past
Mothers and daughters
The never-married Rubmstem (1987) suggests that the never-mamed are not social isolates, but have more fnends to compensate for their lack of family members However, in my sample death of the mother had almost always resulted m a move to smaller living accommodahon m a different area, with the consequent loss of long-known fnends and neighbours Szinovacz (1983) also notes that women do not tend to remain m contact with former co-workers after retirement, and thus a further source of social support is cut off In any case, as women age their contemporanes, whether km or non-km, will mcreasmgly die and leave them unsupported In cases where the mother-daughter relationship resembled that of sisters, its closeness seems to have precluded other intimate relationships Its all-consuming nature additionally meant that some women found themselves without basic copmg skills such as coobng and managing finances, and this compounded their difficulties when bereaved It IS clearly important for community health workers to be aware of these women's potential special needs A district nurse or prachce nurse may be mvolved with or know about the death of the mother, and should anhapate the enormity of the loss caused to a never-mamed daughter by her bereavement Bereavement support and counselling may be even more necessary than for widows who have a family of mamage around them, and commumty psychiatnc nurses may have a role to play here Referral to a sociai worker or health visitor may be appropriate to help the woman manage herfinancesand any change m housing arrangements that may be necessary All health and social workers should be alert to the possibility of depression when never-mamed women lose their parents, but particularly their mothers
Support resources Because their social support resources are likely to be limited, never-mamed women may be in greater need than some others of distnct nursing, home help and meals on wheels when they are acutely ill, discharged from hospital or disabled on a more long-term basis Use of social services IS low for all elderly people (Peace 1986), and Coulton & Frost (1982) observe that those who are most isolated and in need of social services are the least likely to use them As Peace (1986) points out, it is likely that future generahons of older women will have led bves which are more mdependent of their families of ongm, and to have lived alone in earlier life However, mcreased geographical
mobibty may mean that people become more distanced, physically and emotionally, from their famibes Although the needs of elderly single women—and others—may be different in the future, they are still likely to be distinct and worthy of speaal attenhon
CONCLUSION Fennel et al (1988) counsel agamst adopting a 'pathology model' of old age which sees 'old age as rmsery' At the same time they bebeve that it is irresponsible to promote a 'nudist beach' approach which sees old age as a very pleasure-filled time I should like to end this paper with the Ijalamced view' Fennel et al (1988) recommend, by affirming that motherdaughter relationships as descnbed by women m this study left them with many positive and self-affirmmg memones If this were not so, and if they had not gamed a great deal from their mothers, they would not have been the determmed, resolute and mdependent women they showed themselves to be in the mterviews They accepted their circumstances with equanimity and coped with their disabilities with pnde Knowing about their lives can only help us to help them and to understand our own futures better
References Arcana J (1981) Our Mother's Daughters The Women's Press, London Arcana J (1983) Every Mother's Son The Women's Press, London Chodorow N (1978) The Reproduction of Mothering University of Califomia Press, Berkeley Coulton C & Frost A K (1982) Use of social and health services by the elderly Joumal of Health and Soaal Behavior 23, 330-339 de Beauvoir S (1952) The Second Sex Bantam Books, London de Beauvoir S (1959) Memoirs of a Dutiful Daughter Penguin, Harmondsworth de Beauvoir S (1969) A Very Easy Death Penguin, Hamiondsworth Dinnerstem D (1977) The Mermaid and the Minotaur Sexual Arrangements and Human Malaise Harper Colophon Books, New York Elshtam J B (1981) Public Man, Pnvate Woman Pnnceton Umversity Press, New Jersey Fennell G, Phillipson C & Evers H (1988) The Soaology of Old Age Open Umversity Press, Milton Keynes Friday N (1979) My Mother, My Self Fontana, New York
Greer G (1991) The Change Women, Agemg and the Menopause Hamish Hamilton, London 1341
C Webb Hammersley M & Atkinson P (1983) Bhrwgraphy Pnnaples in Prachce Routledge, London Lopata H , Hememann G & Baum J (1982) Lonebness antecedents and coping strategies m the bves of widows In Loneliness A Source Book of Current Theory, Research and Therapy (Peplau L A & Perbnan D eds), Wiley, New York Macdonald B & Rich C (1984) Look Me in the Eye Old Women, Agtng and Agism The Women's Press, London Mitchell J (1974) Psychoanalysts and Femmism Pantheon Books, New York Nighhngale F (1979) Cassandra The Feminist Press, New York Oakley A (1981) Interviewing women a contradichon m terms In Doing Feminist Research (Roberts H eds), RKP, London O'Bnen D & Smith A (1991) In search of destmy Nursmg Ttmes
Peace S (1986) The forgotten female soaal pobcy and older women In Ageir^ and Soctal Pohcy A Cntical Assessment (Phillipson C & Walker A eds), Gower, Aldershot Raymond J (1986) Female fnendship contra Chodorow and Dmnerstein Hypaha 1(2), 4 4 ^ 5 Rubmstem R L (1987) Never mamed elderly as soaal type reevaluatmg some images The Gerontologist 27(1), 108-113 Russell C (1987) Agemg as a femmist issue Women's Studies International Forum 10(2), 125-132 Segal L (1987) Is the Fuhtre Female^ Troubled Thoughts on Contemporary Femintsm Virago, London Szinovacz M E (1983) Beyond the hearth older women and retirement In Older Women Issues and Prospects (MarksonE'W ed), Heath, Lexington Tong R (1989) Femtntst Thought A Comprehenstve Introdtdchon 87(20), 26-28 Office of Population Censuses and Surveys (1989) Soaal Trends Unwm Hyman, London 19 HMSO London Tunstall J (1966) Old and Alone ASoaologtcalShtdy of Old People Payne K (ed) (1983) Between Ourselves Ldters Between Mothers Routledge & Kegan Paul, London and Daughters Picador, London
1342
Mothers and daughters: a powerful spell Chnstine Webb BA MSc PhD SRN RSCN RNT Professor, Department of Nursing, The Universtty, Manchester Ml3 9PT, England
Accepted for publjcahon 30 March 1992
WEBB C (1992) Journal of Advanced Nursmg 1 7 , 1 3 3 4 - I 3 4 2 Mothers and daughters: a powerful spell An unantiapated findmg of a small exploratory study of the health of nevermamed women m old age is discussed Focused conversational interviews yielded evidence of the potent effect the mother-daughter relationship had in a group of women who had lived for all their adult lives in the parental home Usually mothers had outlived fathers, and v*^hen they finally died daughters lost someone to whom they had been very close and at the same time had to cope v>^ith living alone for the first tune in their lives Three case histones, illustrating both strong positive and negative aspects of mother-daughter relationships are reported, and the psychological and sociological literature is explored Parallels are also drawn with biographical and autobiographical literature about this type of relationship, including that of Florence Nightingale and her mother Fmally, some implications for nurses are considered and the special support needs of these women at bereavement and m old age are highlighted INTRODUCTION
eamers (because on average women eam less than men).
Oh, what a power is motherhood, possessmg a potent spell ^^ ^'^''^^ ^o^^e" ^^"^ to work in jobs where pension (Iphigenia m Aulis, Eunpides 405 BC) schemes are less available than m professional-type jobs (Peace 1986) In addition, it seemed likely that the support resources of never-mamed women would be restncted This quotahon sums up an unantiapated theme that because they had no family of mamage and no offspnng to emerged very strongly from a study of the health of never- offer them assistance m old age mamed women m old age, that is the powerful influence on these women of their relahonships with their mothers I became mterested m studying this group of women after My future discovermg that the bterature on women's health rarely mentioned speafically those who had never mamed A further reason for being interested m this group of Where 'smgle' women's health was discussed, reports women is that I am m the same category, and as middle age usually mduded the never-mamed, widowed, divorced approaches I am begmnmg to consider what my future will and separated withm one category The few studies of be like Cnhcs of the feminist movement have noted that never-mamed women were mostly Amencan, which raises hitherto the emphasis m feminist wntmgs has been on queshons about their appbcabibty to the Bntish culture and younger women and on issues related to reprodudion It to our different health care system is only as modem feminists ourselves age that we are It seemed likely that never-mamed women might have beginnmg to tum our attention to issues confrontmg older had different health expenences and needs, because they women (see, for example, Macdonald & Rich 1984, Creer might have acted as Ccirers to elderly parents, peiiiaps 1991) givCTi up work to do this, and therefore were likely to have In this paper I shall descnbe the research methodology bimted fmanaal resources Even if they had had a contmu- and give some biographical information about the women ous work history, they were likely to have been low studied The mam focus will then be on three case histones 1334
Mothers and daughters
that feature the particularly strong relahonships between mothers and daughters, and how they affected the health and bfe courses of the women concemed After discussmg these histones in the light of available bterature, I shall dose the paper by drawmg out some lmpbcahons of the study for nurses—particularly those working m the commumty
THE STUDY Design The study was plarmed as a small exploratory and descnphve one, intended to throw more light on the relatively untapped topic of the health of never-mamed women m old age The approach I chose was that of reflexive ethnography (Hammersley & Atkmson 1983), combmed with a femimst perspedive These two are compatible because the reflexive aspect requires that the researcher gives attention throughout the study to her part m the research encounter and how she influences the data collected and their mterpretahon A femimst approach also draws attention to the fact that, espeaally when women study other women, tradihonal positivishc calls for 'objechvity' are impossible to achieve (Oakley 1981) Instead, in feminist research the researcher attempts to create as equal as possible a relationship between herself and her partiapants, to focus on issues that are important to women themselves rather thim imposing a research agenda from outside their context, and by conceptualizing the research as a means of improvmg women's bves (Russell 1987) Thus, I introduced myself to interviewees both as a nurse researcher who was particularly interested m women's health but also as a never-mamed woman who was eager to find out about their situations because they were of great personal relevance The interviews were conducted in women's homes, were tape-recorded, and lasted between 1 and 2 hours They were arranged through two general practitioners who suppbed the names of suitable women on their registers, and by wntmg to women to explain the study, mvite them to participate and, if they were willing to do so, to retum a tear-off sbp in a stamped addressed envelope On receipt of posihve replies, I contacted women by telephone or by callmg at their homes to make a daytime appointment I considered that daytime rather than evening mterviews were essential so that potential participants would not feel afraid of someone calbng when it might already be dark Also after expenence of evening interviews myself, I was arucious about my own personal safety
when trying to locate house numbers m an unfcimibar area aiier nightfall Interviews were of the focused conversahonal type, and I began by using a health history as the vehicle for gettmg women to talk about their bves and health This seemed the most natural way of approaching the subject because I had introduced myself to them as a nurse and had gained access to them via their general prachtioners I analysed the interviews concurrently so that I could identify emergmg themes and follow these up in subsequent interviews, while continuing to follow the general pattem of taking a broadly ranging health history
WOMEN'S LIFE HISTORIES Fifteen women were interviewed from two diffenng residential distncts on the outskirts of a large metropolitan area Six women bved on a lcirge out-of-town counal housing estate and the other mne were from a more affluent suburb but two of them also lived m flats rented from the local housing authonty Thus there was a broad mix m terms of sociai dass background The mean age of partiapants was 77, with the same median, and a range of 66 to 89 Six had done manual factory work before retirement, two had been office workers, three had been 'nurses' (one occupational health nurse, one midwife, and one unqualified residential nursery nurse), and three had worked m family businesses Despite their rather diverse sociai backgrounds, parhapants were similar m many ways Most notably, all but the three nurses had bved in their parentiil homes all their bves unhl the last parent—usually the mother—^had died All but one of these 12 had subsequently given up the family home and moved mto smaller accommodation All 15 women were bvmg alone at the hme of interview, and had been doing so for a number of years Whilst some had played a canng role for their parents for some penod, none had done this extensively and none had given up work to do so Only two mterviewees had any survivmg family members living dose enough to assist them if they were ill For others, support resources were sparse cmd depended on arrangements which nught well not be sufficient or robust enough if they needed mtensive or long-term assistance Most said that they would rely on a fnend of similar age or a neighbour callmg m to see them and to do shopping Several simply did not know how they would manage They were reluctemt to be admitted to hospital, somehmes because of negahve rep)orts or their own exjienences of hospitabzahon, and did not want to leave their own homes In several cases this was because of fears of burglanes, one 1335
C Webb woman bvmg on the council estate havmg been burgled three times and another four times Their reluctance to go mto hospital might also have been related to even stronger fears about going mto a home' and losmg the highly valued mdependence which had charadenzed much of their bves as never-mamed women Support from statutory services was similarly extremely limited Apart from home helps, and one womam who had meals on wheels, none was in contact with any services other than when she mitiated contact with her general practitioner for repeat prescnphons or an acute problem Only one had had the recently mstituted health screenmg visit from a prachce nurse
Precarious circumstances The group of women mterviewed seemed to be m very precanous circumstances with regard to support and assistance if they became ill, and it was easy to imagme senous implications of this situation Indeed, one partiapant had fallen and broken her collar bone some months earlier but had no telephone and had not been found until her 80-yearold brother-in-law had called m by chance the next day Having pamted a picture of the health and sociai arcumstances of the sample of women mterviewed, I shall now present three case histones to illustrate the strength of mother—daughter relationships m these women who had lived with their mothers until the latter's deaths The three case histones are chosen to illustrate both negahve and posihve relationships, and how influences from childhood can have a lastmg and pervasive effect on thinking and on daily living
CASE HISTORY 1 Miss A was 73 years old and bved m a counal flat in a block which was enhrely given over to 'pensioners' It had centred heatmg, although Miss A could not afford to use this, and relied mstead on an electnc fire I visited her m February dunng a spell of heavy snow, and after bemg there an hour I could hardly feel my fingers and toes Miss A had worked m a factory or as an outworker, domg sewmg, and was rebant on a state pension For the past few years she had been eatmg mto her small savmgs in order to pay everyday bvmg expenses After paymg the 'bills' such as electnaty and gas, she had £ 6 per week of her pension left for housekeepmg Miss A's father had died when she was 16 and for a time she and her mother had bved with her maternal grandmother Later they had moved out and bved together for 1336
another 40 years They had been very dose, 'bke sisters', and descnbmg bfe with her mother, she said She made all the deasions but I carried them out We pooled our money and we only had one purse We didn't have any 'spends', just that purse If one of us needed somethmg—say a new pair of shoes—we saved up and bought it from the purse We did the housework together Her mother had died at the age of 90 after a penod of 'going downhill' She had been mentally alert until losmg consaousness and dymg at home 2 weeks later of pneumonia Tcilkmg of her mother's death. Miss A said, I thought a lot of her It was a big blow but I knew she was slipping away Because they had lived m their counal house for many years. Miss A had 'a lot of fnends and neighbours then' who had supported her But continuing to live in the house was too much for her because her mother 'was everywhere, m all the rooms, all round the house' So she had moved to her present flat, and was pleased to have done so, although she shll thought a great deal about her mother and said, 'she could have lived here—we could have got two single beds mto the bedroom'
Contacts Since movmg to her flat. Miss A had lost touch with her former fnends and neighbours, and now only had one fiiend This was a widow, bvmg m the same block, whom she had known for 50 years and had met through her church However, this fnend had recently gone mto hospital and it seemed unbkely that she would retum to bve in her flat Miss A's only soafd contacts now were at church on Sundays Her niam pastime was watching television She had given up her weekly home-help because she could no longer afford it One thmg that had always bothered Miss A and contmued to do so was that people usually addressed her as 'Mrs A' She said, I get called Mrs A all the time and I don't bke it My mother was Mrs A but I've got weary of telling people
CASE HISTORY 2 was 84 and she had bved with her mother, agam like two sisters' from 1939 to 1967 when her mother died
MISS B
Mothers and daughters
Her father had died when she was a child and she had gone to live with her grandparents Her mother remamed but this second husband also died and Miss B had retumed to bve with her mother Mrs B had had a hysterectomy and 2 years later, aged 29, Miss B had one also and so they were able to share this and so many other expenences Miss B descnbed herself as the tenant of the accommodation she shared with her mother, but it had been her mother who had taken all the deasions Miss B accepted this because they were so dose She descnbed her mother as 'a sfrong spmt but not physically sfrong', due to a 'damaged throat from sucking a doll pamted with lead paint when she was a child' Miss B had always done the housework but her mother had done the cooking Of her mother's death she said.
dressed her mother and sat her m a chair Her mother had behaved selfishly dunng this penod, insisting that the home-help spent hme with her rather than domg the housework, so that Miss C had to do this too Her mother had been unable to walk, but Miss C was not sure why this had been and seemed to be suggesting that her mother could have been more independent if she had wanted to be When her mother had died Miss C had been very sad She had always had a chip on her shoulder My brother died when he was 6 and she turned round and said 'I wish it had been her' (Miss C) After she died I found I had been bom out of wedlock She should have told me I found out through a birth certificate Other people knew, but not me I kept thinking about hints, etc, on my father's side They more or less pushed me out I'd have liked to know I thought she could have trusted me better Sbe was a good mother, but most of it was just duty
When she died the biggest difference was not having a cooked meal ready when I came in I lacked confidence in cooking I could cook but she always told me what to do I missed her I came m and thought 'I must tell my mother that'—^but Attachment to mother sbe wasn't there She explamed how she had really only leamed to cook after her mother died, and that after a few weeks she had realized that the house was getting very untidy because nobody was tidying up and putting thmgs away as her mother had done She had to leam these basic housekeeping skills, as well as plannmg and budgeting and seeing that the bills got paid Of the financial side of things, she commented That was a bit gnm I was m a bit of a pickle when it was just my wage I just had to sweat it out—I just leamed the hard way
CASE HISTORY 3 Miss C was 81 and seemed very frail She said that she had been healthy up to the age of 60, although she had been 'delicate' as a child following rheumatic fever which had left her with mitral valve damage She had had a mastectomy 10 years earber, but her mam problem now was severe arthntis which meant that she was virtually chairbound As a child she had lived with her grandparents unhl she was 12 because her mother had been 'm service' At the age of 12 she had been sent to live m a convent school and on leaving there had been in lodgings for 4 years unhl going to bve with her mother m rented rooms She had then bved with her mother continuously until the latter's death m 1973 at the age of 89 Miss B had cared for her mother as she became older, but had contmued m paid employment She washed and
Miss C, then, bke Miss A and Miss B, had had a very strong attachment to her mother, but the relationship had not been of the same posihve quabty The long years of her mother's resentment against her because she had become pregnant with Miss C before getting mamed still weighed very heavily, and Miss C cried as she told me her story She had worked for some years in a children's nursery and said of this Some of the children I've looked after never knew their fathers—it didn't make any difference In saymg this she seemed to be expressing the fact that it should not have made any difference to the way her mother had treated her, and the fact that it had done so was still a source of great distress to her
MOTHER-DAUGHTER RELATIONS Simone de Beauvoir (1952) wntes of ambivalence m mother-daughter relahonships, descnbmg daughters as both the 'prey' and the 'double' of their mothers In de Beauvoir's view, the role of wife depnves women of their freedom but the role of mother does so even more Accordmg to Tong's mterpretation of de Beauvoir's wntmgs, pregnancy abenates a woman from herself because once encumbered with a child she is unable to control her own destiny At first the creativeness of having a child may seem to liberate a mother, but reanng a child is very demanding and tums the woman into 1337
C Webb an object, a machme for cooking, clearung, canng, giving and esp>eaally sacnfiang Reduced to an object, the mother, not unexpectedly, begms to view and to use her child as an object, as something that can make up for her deep sense of frustration (Tong 1989)
De Beauvoir (1952) believes that, m companson with sons, mother-daughter relationships are much more dramatic [The mother] projects upon her daughter all the ambiguity of her relation with herself It is between mother and daughter that the conflicts take aggravated form This view follows from de Beauvoir's conceptuabzation of women as 'other', m that men see the world in their own tenns and consider women as different and 'other' than them rather than having unique charactenstics of their own Elshtam (1981) cntiazes de Beauvoir on three counts First, her ideas do not relate directly to women's bved expenence Her wnhngs use language and concepts which are abstract and philosophical and only likely to be able to be understood by highly educated women The second cnhasm is that de Beauvoir sees the female body m negahve terms, as 'burdensome' and 'inherently alienahng' She was concemed about the way that the female body places burdens on women that are much greater than those of the male, and saw this female body as bmitmg women's freedom This distrust of the female body prevents de Beauvoir from celebrating its pleasures and capacities, and is likely to put off women who regard aspects of sexuality such as childbirth, pregnancy and breastfeeding as positive exf>enences Elshtam's (1981) third cnhasm is related to de Beauvoir's seeming acceptance of male norms By devaluing the female body she is implying an opposite acceptance of and preference for the male body and character She saw women as achievmg freedom by followmg the ways fraditionally adopted by men As Elshtam puts it To ask women to give up their female identities, without considenng the ramifications of trading m sisterhood for the universal brotherhood of mankmd, is irresponsible De Beauvoir wrote from her own perspective as a highly educated middle-class French woman Her wnhngs had great appeal and influence for similar women, who found what she wrote liberating She was concemed that women
should not be limited by their biology but should be able to 1338
determine their own existence, within the limits imposed by soaal structures (Tong 1989) Sociai processes After de Beauvoir, the most influential wnter on motherdaughter relationships is perhaps Nancy Chodorow Like other feminist wnters such as Juliet Mitchell (1974) she sought to use psychoanalyhc work to elucidate sociai processes, rather than relymg on biologically based explanations (Chodorow 1978) Chodorow (1978) believes that it is the fad that women are responsible for mothenng, and men play bttle or no part, that determines the psychological development of children and accounts for the intense emohonal bonds between girls and their mothers She recognizes that these emohonal hes can be those of anger as well as of love, or even a mixture of the two which she terms a 'double life' She claims that strong mother-daughter relationships are a re-creation of mothers' own relationships with their mothers Mothers see their daughters as less separate from themselves than their sons, and therefore form closer bonds with them, and girls always retam this early identification with their mothers This relahonship will always be stronger than the father-daughter relahonship because fathers take so bttle part m childreanng Girls' identification with their mothers leads to their greater empathy and sensitivity to others, and thus in tum their own desire to mother is almost mevitable
Mother-son Mother-son love is different, according to Chodorow (1978), because it is less 'narassistic' and is focused on someone who is different from themselves To develop a masculme ldenhty boys must separate themselves from their mothers as their early love objects and must reject their previous attachments and ldentificahon with their mothers This process leads men to feel the need to demonstrate their differentness from women, and to dommate them Chodorow's work, like that of de Beauvoir, has been very influential among femimsts It has foimed the basis of a femimst therapy movement, and particularly the work of Eichenbaum and Orbach at the London Women's Therapy Centre Their therapy focuses on the centrality of the mother-daughter relahonship, as a result of which daughters have leamed from their mothers to repress their own emohonal needs and to feel unworthy and rejected The therapeutic process aims to
Mothers and daughters
rebuild the cbent's 'sense of self and confirm that she needs and deserves to be taken care of and wiU—through the 'repair work' of therapy—begm to grow in strength and autonomy (Segal 1987)
Despite its success as a basis for therapy, a number of important cnticisms can be made of Chodorow's work She puts forward a somewhat mechamstic picture of women as all behaving the same, despite differences of social dass, race and stage in history It is as if all mothers at all stages m history and in all cultures reared their children in preasely the same way The fact that some women are mamed and others are smgle parents, financial circumstances differ greatly, women have varying levels of educahon, and a host of other factors, contnbute to multitudinous ways of reanng children and not the 'psychic essentialism' descnbed by Chodorow (Segal 1987) It IS by no means universally accepted that Chodorow's solution of dual parenting will lead to improvements for women (Tong 1989) Elshtam (1981) asks whether men will become better if they share in childreanng and women will become worse It might be that both girls and boys will benefit because boys will no longer feel the need to control women and curb their emotional side, while women will gam in authonty and power while remammg canng (Dmnerstein 1977) Elshtam considers that, by shanng parenting with men and participating to a more equal extent also in the world of work, women will take on male aggressiveness Janice Raymond (1986) is m favour of equal parenting if it leads to men becoming more nurturant and to future children being less misogymstic However, this strategy gives men the status of 'saviours', and gives them even greater power than they now have withm the family as well as outside There is so far no agreement, then, about whether the overall effects of ducd parenting would be negahve or positive for women, men, girls or boys Beyond the soaological and psychological bterature, there has also been great mterest in mother-daughter relationships in recent years Nancy Fnday's My Mother, My Self (1979) is one of a genre of books emanating from the USA Fnday's work is autobiographical, while Judith Arcana's Our Mother's Daughters (1981) is based on interviews with women Arcana descnbes her wnting of the book as
impelled by a passion to know and understand my own mother, to overcome the gnef and pain of our bond, and to strengthen the true, deep connection between us as women (Arcana 1983)
Karen Payne's (1983) edited collechon of letters between mothers and daughter is enhtled Between Ourselves, and illustrates the 'sometimes strong disapproval, even violent disagreement across the generations' but also includes mothers and daughters who have encouraged each other to go far beyond the conventional definitions of good mothers and dutiful daughters, and have given each other crucial support The phrase 'dutiful daughters' is a reminder that Simone de Beauvoir also wrote about her relationship with her mother in Memoirs of a Dutiful Daughter and A Very Easy Death (De Beauvoir 1959,1969)
Nightingale myth Closer to home, the Nightingale myth has recently been challenged by analyses of her personabty and family relationships Florence was a disappointment to her mother, Fanny, and to her elder sister, Parthenope Although reputedly a young woman of great beauty and m great demand m 'society', Florence was determined to realize her vocation as a nurse Accordmg to Payne (1983) By the age of 30 her sense of calling had not diminished m the slightest, although her mother's contmued frustration of her goal had led Florence to suffer from hallucinations, insomnia, complete disinterest in soaal life, and an acute desire to die Family fnends, the Bracebndges, were extremely womed about Florence's physical and mental health and took her abroad on several holidays On one of these tnps, Florence spent 2 weeks at the Instituhon for Deaconesses at Kaiserswerth, a rebgious hospital, but still her mother resisted her ambitions This contmued opposition by her mother and sister led Nightingale to wnte Cassandra, a pamphlet m which she expressed her anger at the thwartmg of women's 'passion, mtellect, moral achvity' She concluded that the family IS too narrow a field for the development of an immortal spirit The family uses people not for what they are, nor for what they are mtended to be, but for what it wants them for— its own uses It thinks of them not as what God has made them but as the something which it has arranged that they shall be This system dooms some minds to incurable infancy, others to silent misery (Nighhngale 1979)
After fmally succeeding m gomg to work in the Crimea, Nightingale retumed to this country and bved as an mvcilid 1339
C Webb for most of the rest of her life Her difficult relationship with her mother and sister contmued, and affeded her mental health Although her 'illness' appeared to be predominantly a physical one, it seems dear that the emohonal aspects were the underlying problem (O'Bnen & Smith 1991) Payne (1983) traces much of Nightingale's behaviour back to the mother—daughter relationship She wntes Despite the numerous danng, mtelbgent and supportive women whom she met and worked with, Florence never seemed able to overcome her feebngs of distrust, based on her relahons with Fanny and Parthe She felt that she could not rely on women and never really believed most women capable of anything other than petty domestic tyranny Her joumal entry in 1857 about 'the real fathers and mothers indicates that she did not thmk that Fanny had mothered her—certamlv not m any positive sense
DISCUSSION The case histories show that Miss A and Miss B retained throughout their bves the strong attachments and ldenhfication with their mothers descnbed by Chodorow (1978) This was true for Miss B even though she had partly been brought up by her grandparents and had bved apart from her mother for much of her childhood and teenage years Miss C had also been brought up by grandparents and then gone to a residential school Living apart from her mother for some of her formative years had similarly not diminished the strong emotional ties Miss C felt with her mother, despite a lifetime of resentment on her mother's part Her mother had continued to be 'difficult' towards Miss C even when she was canng for her in old age Their bondmg seemed to be marked by the 'gnef and pam' descnbed by Arcana (1983), or to be like the 'double life' identified by Chodorow (1978) Miss C's story parallels that of Florence Nightingale's relahonship with her mother Despite a lifehme of 'petty domestic tyranny' (Payne 1983), both women had cared for their agemg mothers as the latter's health declined despite suffenng poor health themselves The profound bonding that had taken place m the very early years for Miss B and Miss C had endured despite later childhoods m which they lived with grandparents and only saw their mothers on visits For all three women, emohonal dependence on their mothers seemed to have replaced the role that might have been taken by a spouse They revealed elements of lack of autonomy, in emotional coping and coping with activities of daily livmg which have been descnbed in relahon to widows (Lopata et al 1982) The 1340
strength of their maternal hes had cut them off from other confiding relahonships and left them soaally isolated m old age If they had not lived so closely with their mothers, they might have formed finendships and had confidantes who could have offered mutual support in old age There is a great deal of evidence, then, in both literary and saenhfic wntmgs, of the power, ambiguities and ambivalence that be behind mother-daughter relationships The case histones presented mirror what is found m the bterature and attest to the continuing very real influence of this relationship on women's bves, an influence which cames through mto their own old age
IMPLICATIONS FOR NURSES Never-mamed women are a sigmficant mmonty and form an increasmg proportion of the elderly population (OPCS 1989) The data from this study, while being collected from a small and non-representahve population, nevertheless suggest issues that are important for the care of never-marned women in old age The particular cohort studied may be among the last of what has been termed a distinct soaal type' (Rubinstein 1987) Family pattems and lower levels of geographical mobility than today meant that women who did not marry tended to remain in the parental home for most of their bves The case histones descnbed show that motherdaughter relationships retained an intensity that might have been transferred to husbands, had the women mamed It is therefore not surpnsing that mothers' deaths constituted a major bfe event for these elderly daughters, and this condusion matches that of Rubmstem (1987), who wntes Tliere exist for some [never-mamed people] deep feebngs of loss and abandonment upon the death of parents [who] were co-residents into mid- or late-bfe Theirs is not an unfelt, lossless old age, a conclusion that might be inferred from a focus on the lack of mantai bereavement Tunstall (1966) draws similar conclusions When speaking of their parents' deaths they [smgle old people] sound strangely bke widows talking about their husbands dying The majonty have continued to live with their parents It is hardly surpnsing that a single woman should have been especially devoted to a parent [usually a mother] with whom she had bved for forty-three years Given, further, that the death of this second parent often left the single person bving alone for the first time in her life the second parental death becomes a uruque watershed m the single person's past
Mothers and daughters
The never-married Rubmstem (1987) suggests that the never-mamed are not social isolates, but have more fnends to compensate for their lack of family members However, in my sample death of the mother had almost always resulted m a move to smaller living accommodahon m a different area, with the consequent loss of long-known fnends and neighbours Szinovacz (1983) also notes that women do not tend to remain m contact with former co-workers after retirement, and thus a further source of social support is cut off In any case, as women age their contemporanes, whether km or non-km, will mcreasmgly die and leave them unsupported In cases where the mother-daughter relationship resembled that of sisters, its closeness seems to have precluded other intimate relationships Its all-consuming nature additionally meant that some women found themselves without basic copmg skills such as coobng and managing finances, and this compounded their difficulties when bereaved It IS clearly important for community health workers to be aware of these women's potential special needs A district nurse or prachce nurse may be mvolved with or know about the death of the mother, and should anhapate the enormity of the loss caused to a never-mamed daughter by her bereavement Bereavement support and counselling may be even more necessary than for widows who have a family of mamage around them, and commumty psychiatnc nurses may have a role to play here Referral to a sociai worker or health visitor may be appropriate to help the woman manage herfinancesand any change m housing arrangements that may be necessary All health and social workers should be alert to the possibility of depression when never-mamed women lose their parents, but particularly their mothers
Support resources Because their social support resources are likely to be limited, never-mamed women may be in greater need than some others of distnct nursing, home help and meals on wheels when they are acutely ill, discharged from hospital or disabled on a more long-term basis Use of social services IS low for all elderly people (Peace 1986), and Coulton & Frost (1982) observe that those who are most isolated and in need of social services are the least likely to use them As Peace (1986) points out, it is likely that future generahons of older women will have led bves which are more mdependent of their families of ongm, and to have lived alone in earlier life However, mcreased geographical
mobibty may mean that people become more distanced, physically and emotionally, from their famibes Although the needs of elderly single women—and others—may be different in the future, they are still likely to be distinct and worthy of speaal attenhon
CONCLUSION Fennel et al (1988) counsel agamst adopting a 'pathology model' of old age which sees 'old age as rmsery' At the same time they bebeve that it is irresponsible to promote a 'nudist beach' approach which sees old age as a very pleasure-filled time I should like to end this paper with the Ijalamced view' Fennel et al (1988) recommend, by affirming that motherdaughter relationships as descnbed by women m this study left them with many positive and self-affirmmg memones If this were not so, and if they had not gamed a great deal from their mothers, they would not have been the determmed, resolute and mdependent women they showed themselves to be in the mterviews They accepted their circumstances with equanimity and coped with their disabilities with pnde Knowing about their lives can only help us to help them and to understand our own futures better
References Arcana J (1981) Our Mother's Daughters The Women's Press, London Arcana J (1983) Every Mother's Son The Women's Press, London Chodorow N (1978) The Reproduction of Mothering University of Califomia Press, Berkeley Coulton C & Frost A K (1982) Use of social and health services by the elderly Joumal of Health and Soaal Behavior 23, 330-339 de Beauvoir S (1952) The Second Sex Bantam Books, London de Beauvoir S (1959) Memoirs of a Dutiful Daughter Penguin, Harmondsworth de Beauvoir S (1969) A Very Easy Death Penguin, Hamiondsworth Dinnerstem D (1977) The Mermaid and the Minotaur Sexual Arrangements and Human Malaise Harper Colophon Books, New York Elshtam J B (1981) Public Man, Pnvate Woman Pnnceton Umversity Press, New Jersey Fennell G, Phillipson C & Evers H (1988) The Soaology of Old Age Open Umversity Press, Milton Keynes Friday N (1979) My Mother, My Self Fontana, New York
Greer G (1991) The Change Women, Agemg and the Menopause Hamish Hamilton, London 1341
C Webb Hammersley M & Atkinson P (1983) Bhrwgraphy Pnnaples in Prachce Routledge, London Lopata H , Hememann G & Baum J (1982) Lonebness antecedents and coping strategies m the bves of widows In Loneliness A Source Book of Current Theory, Research and Therapy (Peplau L A & Perbnan D eds), Wiley, New York Macdonald B & Rich C (1984) Look Me in the Eye Old Women, Agtng and Agism The Women's Press, London Mitchell J (1974) Psychoanalysts and Femmism Pantheon Books, New York Nighhngale F (1979) Cassandra The Feminist Press, New York Oakley A (1981) Interviewing women a contradichon m terms In Doing Feminist Research (Roberts H eds), RKP, London O'Bnen D & Smith A (1991) In search of destmy Nursmg Ttmes
Peace S (1986) The forgotten female soaal pobcy and older women In Ageir^ and Soctal Pohcy A Cntical Assessment (Phillipson C & Walker A eds), Gower, Aldershot Raymond J (1986) Female fnendship contra Chodorow and Dmnerstein Hypaha 1(2), 4 4 ^ 5 Rubmstem R L (1987) Never mamed elderly as soaal type reevaluatmg some images The Gerontologist 27(1), 108-113 Russell C (1987) Agemg as a femmist issue Women's Studies International Forum 10(2), 125-132 Segal L (1987) Is the Fuhtre Female^ Troubled Thoughts on Contemporary Femintsm Virago, London Szinovacz M E (1983) Beyond the hearth older women and retirement In Older Women Issues and Prospects (MarksonE'W ed), Heath, Lexington Tong R (1989) Femtntst Thought A Comprehenstve Introdtdchon 87(20), 26-28 Office of Population Censuses and Surveys (1989) Soaal Trends Unwm Hyman, London 19 HMSO London Tunstall J (1966) Old and Alone ASoaologtcalShtdy of Old People Payne K (ed) (1983) Between Ourselves Ldters Between Mothers Routledge & Kegan Paul, London and Daughters Picador, London
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