Resistances to psychotherapy with the elderly

This exploration of the contribution of psychiatrists to the underutilization of psychiatric services by the elderly focuses on the therapists' resistances to psychotherapeutic work with older patients. These resistances can be understood as reflecting two very different types of processes. One involves cognitive misunderstandings of both the phenomenology of normal aging and the nature of age-specific adaptive coping mechanisms. The net result of such cognitive misunderstandings is that the psychiatrist interprets as psychopathology that which is part of normative aging. The second type of resistance involves empathic failure. Psychotherapists fail to respond to the affective component of the elderly patient's dilemma because to do so involves the risk of arousing unresolved feelings regarding their own aging and death or that of their parents. These resistances contribute to the myth that elderly patients are unavailable for appropriate psychotherapeutic exploration.