Treatment of the older adult: the impact on the psychoanalyst

Work with the elderly challenges analysts in special ways. The author presents clinical material from her practice and from investigative interviews with nine treating analysts who report personal reactions and countertransferences to analytic work with twelve elderly patients. She concludes that the major challenges in work with the elderly come more from the analyst than from the patients. Issues arising from the analyst's unresolved feelings about aging, parents, loss, and death are revived in the treatment of the elderly in an especially intense form. In this paper many aspects of transference are considered, especially those relating to illness, loss, and the problems that flow from identifications of the older analyst with the patient. The affective reverberations in younger and older analysts with regard to the initiation of analytic treatment, the inevitability of moving in and out of real life crises, the sustaining of loss, and, particularly, the impending termination, are presented in the paper.