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We see which way the stream of time doth run And are enforc'd from our most quiet shore
It is remarkable that more than half a century elapsed before the subject of The ‘Applicability of Psychoanalytic Treatment at an Advanced Age’ raised by Abraham (1919) was re-opened by King . Certainly Freud (1904, 1905) had given his reasons for considering ‘old people are no longer educable’, but Sandler (1978) has suggested that his view was coloured by personal anxieties and preoccupations about ageing. So it seems possible that the quotation may account for the lapse of time between Abraham and King.
Since King wrote ‘Notes on the Psychoanalysis of Older Patients’ a number of analysts have found that some older people can respond to this form of treatment.
Psychotherapy for those in later life is still unusual, and as far as I know it is only Bella and Small who suggest that brief psychotherapy may be of particular use to those in later life. Brief psychotherapy has been developed by Malan (1976) and colleagues, and criteria have been worked out by extensive clinical and research experience. The two triangle technique described by Malan (1979) has been extended by Molnos (1984) and I have found it a most useful conceptual framework. I first attempted brief psychotherapy with an older patient when I worked with an aged man suffering from unresolved grief (Hunter 1981). It was this experience which led me to attempt it again with the patient who forms the subject of this paper.
I shall refer to the patient as Mary. She was sixty-eight and was referred as suffering from unresolved grief. There is extensive literature on the subject of grief but it is Tyson's (1983) paper which is particularly relevant to my work. He draws attention to the need to understand, from a developmental perspective, the effect of object loss on the narcissistic equilibrium of the bereaved and considers omnipotence, self-constancy and self-esteem the special components of this equilibrium. T