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There are very few books I would send to friends as holiday gifts. Amy Schaffer’s moving discussion of therapy with older patients qualifies, for its combination of fine scholarship and contagious inspiration. Amply referenced, yet highly readable, Schaffer’s book delivers its survey of the joys and heartaches of clinical treatment of older adults without ever failing to be admirably honest. She is explicit about the personal gratifications of this work, as well as its tolls.
Schaffer’s opening chapter situates psychological treatment in later life in the context of current models of psychoanalytically informed therapy. The next six chapters focus on childhood tasks and traumas that can be recruited by challenges encountered in later life, the problems inherent in the aging process, frequent relational patterns between older adults and their therapists, the benefits of creating a narrative of one’s life, and the author’s clinical experience of grappling with death, mourning, and endings. The subject can be daunting, but Schaffer’s evident compassion makes it extremely readable and engaging.
While this book inevitably raises personal issues for the reader (and, assuredly, for this reader) it also suggests problems that are embedded in the psychoanalytic and the wider culture. For me, its backdrop includes a host of complicated conflicts about registering suffering, in myself, those in my immediate surround, and others, whose situations are further removed from my own. I have become convinced that there is an important analogy between how I focus visually, in the presence of evident suffering, and how my mind’s eye regards it.