Psychotherapy with an Eighty-Year-Old Patient

Abstract

Psychodynamic aspects of treatment for older adults have long been misunderstood or underappreciated. Such has been the situation with the elderly in general and those of advanced age in particular. Part of the explanation for this repeating scenario is simple. Psychiatric experience and psychotherapeutic approaches with older patients have been sparse. Moreover, case reports in the literature have been too few, and comments about such efforts have sometimes been contradictory. Consider, for example, the divergent impressions of Sigmund Freud and Karl Abraham. In 1905 Freud indicated that,

The age of patients has this much importance in determining their fitness for psycho-analytic treatment, that, on the one hand, near or above the age of fifty the elasticity of the mental processes, on which the treatment depends, is as a rule lacking—old people are no longer educable—and, on the other hand, the mass of material to be dealt with would prolong the duration of the treatment indefinitely, (p. 264)