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A paper read before the New York Neurological Society to show that the old age factor need not necessarily rule out psycho-analytic treatment in otherwise appropriate cases.
It is pointed out that chronological, physiological and psychological old
age do not necessarily synchronize. At one time the writer used to believe that some acquaintance with his unconscious would be of benefit to the patient in the treatment of his symptoms. But now he is more inclined to tell his older patients that disease symptoms are intuitively formed compensations for inner character defects, and that their fundamental beliefs will be profoundly stirred by psycho-analytic treatment; that they won't like it, but that much may be done provided they have the courage to look into themselves.
He could quote from his practice numbers of cases in which he had used psycho-analysis in those over fifty years of age without any result whatever, but still his faith in the efficacy of the principles are not shaken. In all such cases he was able to convince himself that there were clear indications why any real revelation on the part of the patient would not be conceived of by him as being advantageous. In other words, his neurosis or psychosis was a better solution of his life difficulties than anything he could offer by treatment. How far psycho-analysis can be applied in those who have passed through youth fairly successfully and in mature years have begun to regress to phantasy formation one never can tell.
Several cases are quoted from his practice in which psycho-analytic treatment was employed with success. In some of the cases quoted, however, the pure psycho-analytic technique does not seem to have been employed.