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Neuroses and character disorders

D Blau, M A Berezin

    Journal of Geriatric Psychiatry
    |January 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Older adults with neuroses and character disorders are frequently overlooked. This paper advocates for their treatment, highlighting that individual assessment and dynamic understanding are crucial for effective psychotherapy in the aged.

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    Area of Science:

    • Geriatric Psychiatry
    • Psychotherapy with Older Adults
    • Mental Health of the Aged

    Background:

    • The aged with neuroses and character disorders are a significant population often neglected by mental health professionals.
    • Stereotypes and myths about aging contribute to therapeutic nihilism and pessimism, leading to the neglect of older individuals' emotional distress.
    • Unconscious motivations for ignoring the distress of older adults are explored, alongside specific myths like the "rigidity" of the aged and viewing all pathology as organic.

    Observation:

    • Clinical examples illustrate common emotional problems in non-institutionalized older populations, analyzed through dynamic understanding and management.
    • The paper examines the persistence of childhood unconscious attitudes, fantasies, and wishes, noting their potentially altered significance in old age.
    • Concerns about death and countertransference issues in working with the aged are discussed, emphasizing the need for flexibility and genuine concern from therapists.

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    Findings:

    • A trial of observation and psychotherapy is recommended for all older patients, as even "organic" signs may be reversible with treatment.
    • Individual assessment and understanding are paramount, avoiding generalizations about the aged to prevent stereotyping and encourage scientific investigation.
    • Psychotherapy can lead to increased insight, a greater capacity to enjoy life, and comfort derived from the therapeutic relationship.

    Implications:

    • Effective treatment can help older adults achieve greater self-esteem through reminiscence and better tolerate life changes, including evolving feelings about goals, sexuality, and relationships.
    • Therapeutic interventions can assist patients in accepting regressive behaviors and assimilating changing life perspectives.
    • A flexible, engaged, and concerned therapeutic approach is vital for successful outcomes, with patients valuing genuine involvement.