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Professor Robert Kastenbaum, in his excellent foreword to this book, describes the terror we feel when confronted by old age and its eventual accompaniments: physical decrepitude, mental deterioration, helplessness and death. He notes, and the book describes, the evasions and defences we use to avoid panic when faced with these issues in our patients, our kith and kin and ourselves. Kastenbaum quotes the twentieth century North American poet Winfield Townley Scott: ‘Whom do the mourners see? Themselves. Themselves. …’. This is what the book is about: the professional helpers, and our own, feelings when we are in touch with elderly individuals.
Countertransference is defined in its widest sense as all the feelings that are experienced by those who work with the elderly. The book discusses how helpers can become aware of, acknowledge, understand and use these feelings to help their clients. The most common countertransference reactions are named as ‘anger and resentment; inadequacy and failure; powerlessness and lack of control; frustration and guilt; sadness and grief; fears or aging, emotional pain, losses, dependency and death’.
The contributors are psychoanalytically-experienced psychotherapists with a background of sociology and social work. So this is a practical book. It contains a number of guidelines and check-lists, and a self-awareness quiz to test our own feelings and fears of decrepitude and death. Two tables in the final chapter set out the effect of the professional helpers' countertransference responses on the client; and early signs of negative countertransference. The authors make the point that these responses in the helpers come not only from their reactions to their clients but also from their upbringing and development, their prejudices, and their past and present relationships with family, friends and colleagues. The focus is on the professional helpers and on case work rather than on psychodynamic concepts of transference and countertransference