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Prevention until recently has been regarded as applicable to very few problems in psychiatry; it was used in areas such as epidemiology, genetic counseling, population control, and ethology. In psychiatry the concept of prevention within the context of a complete human life cycle has, however, been slowly evolving as we have begun to study adult personality patterns and behaviors and adult generative tasks, placing equal value in development on all stages of the adult life cycle from young adulthood to old age.
The pioneer work in this area of conceptualization began in 1953 with the work of Kluckhohn and Murray on Personality in Nature; Society and Culture.1 At the same time, Erikson began to conceptualize his framework of the eight stages of man, which included developmental tasks of adulthood for the first time.2 Buhler and her students, who had been studying human life cycles since the 1930s in Vienna, published their work in 1968.3 In 1933 Jung defined a series of stages in the human life cycle, viewing death as a goal toward which one can strive; he viewed shrinking away from death as unhealthy, robbing the second half of life of its purpose.4
The term “middle age” as seen within the continuum of the human life cycle is arbitrarily defined as beginning around age 35 or 40 and lasting to 50 or 55.
Various authorities have defined it somewhat differently,5, 6 but, in general, with regard to phase-specific tasks, it is that time of life when one has achieved intimacy, parenthood, and stability in an occupation—i.e., both a gender identity and a role identity that is stable.
Erikson7 defines the challenges of middle life as the following: (1) valuing wisdom versus physical power, (2) socializing versus sexualizing in human relationships, (3) widening involvements outside the home as children leave and parents die (cathectic flexibility versus cathectic impoverishment), (4) mental flexibility versus mental rigidity. It is obvious, therefore, that the important shift in