As a psychiatrist in Manhattan, it is not uncommon for me to see somebody who, after years of living a productive life, is dissatisfied upon entering late middle age and retirement.

But far more often, I see the exact opposite: energetic older individuals entering the “third act” of life with an enviable and beautiful joie de vivre.

So what differentiates those who are fulfilled in their “third act” of life from those who are not?

Psychologist and psychoanalyst Eric Erikson described the years after age 60 as time to reflect and reconcile the lives we have lived and the key choices that have defined us.

This stage entails recognition of our own mortality and the understanding that we live on and gain proverbial immortality through our extended family, our community, and the various contributions we have made over the course of our lives.

Erikson describes this developmental stage as a time when human beings seek to reconcile the conflict between “integrity vs. despair.”

The most important part of this developmental stage of life is coming to terms with the choices and events that have made our lives unique and accepting our lives for what they are.

When one is able to do this, one develops a sense of integrity.

Older adults that reach integrity become self-affirming and self-accepting, and they judge that their lives have been, for the most part, worthwhile and good. They feel a sense of fulfillment about life and accept death as an unavoidable reality.

In contrast, if a person looks back on their life with predominant feelings of dissatisfaction, shame, guilt, and regret, they develop despair. They may feel bitterness because of what they were not able to do in their lives, longing to turn back the hands of time for second chances.

They focus more on their failures and, as such, may experience fear of death, as they are still not done with searching for their life’s meaning and still wondering, “What was the point of life?”

The most powerful way to deal with death anxiety is to engage in the adage of living each day as if it were your last, without fear or regret.

Although death itself will lead to the end of our physical life, as we know it, the recognition that life is finite may be the very thing that opens us up to our aliveness.

Ways of reaching Erickson’s state of integrity, as opposed to despair, and reconciling the very human feeling of death anxiety include:


• Embracing your authenticity (that which has made your life unique and special)

• Recognizing the legacy you have created through your relationships and the work you’ve done in this world

• Embracing your freedom by taking full responsibility for your life


At the same time, it entails seizing the third act of life with openness, joy, and presence: trying new things, learning new skills, engaging in creative activities, telling your story to others, living with purpose, fostering meaningful connections, and, most importantly, living mindfully and in the present moment.

None of these things will make you immortal, but they will enable you to live the life you have on earth most fully. By living in a constant state of presence, we begin to appreciate the miraculous in the mundane.

As Albert Einstein once said, “There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.”


Dr. Anna Yusim is an award-winning psychiatrist and author of Fulfilled: How the Science of Spirituality Can Help You Live a Happier More Meaningful Life (Hachette, June 2017).

Have questions?

We are just a click away!