The Use of Psychoanalytic Principles in the Treatment of Older People

If we ask the question, Is the use of psychoanalytic principles indicated in the treatment of older people? we have to define both psychoanalytic principles and older people. It is evident that both terms contain a multiplicity of concepts, so that without definition of either term an answer of yes or no becomes meaningless.

Let us start with psychoanalytic principles. To state first what it does not mean: It does not mean “psychoanalysis” in the Freudian sense, and rigid analysis along the lines established by Freud has, to my knowledge, not been thoroughly evaluated as yet. In any case, it was not attempted by me. Since I was educated at the American Institute of Psychoanalysis I have used the method outlined by Karen Horney, but, while using her basic concepts, I had to modify my therapy, in order to adjust it to the special needs of my older patients. Psychoanalytic principles should therefore be defined as my therapy based on the principles outlined by Karen Horney, specifically in her two later books Our Inner Conflicts (1) and Neurosis and Human Growth (2). The content of what I consider the cornerstones of Horney's edifice of psychoanalytic theory will be discussed later.

Second, we need a definition of older people. At first blush, this seems to be an easy undertaking: Why not call “older people” anyone 65 years old or older? Let us content ourselves for a moment with this definition. The question arising immediately is this: Is such an artificial separation caused by this definition meaningful to the analyst? Would the fact that a patient is 67 instead of 34 years old make any difference in terms of goals or technique to the psychoanalyst and, if so, in what way? A second question is, Are not other categories such as gender, economic standing, social and educational standing, physical health, ethnic background, nationality, religious background, etc., much more important in the scale of factors determining the kind of therapy indicated for our patient than a