Fear of Death—Notes on the Analysis of an Old Man1

This communication is based on the analysis of a man who came to treatment at the age of 73½ and whose analysis was terminated just before his 75th birthday. He had suffered an acute psychotic breakdown when he was nearing the age of 72. Following the usual psychiatric treatments (electric shocks, etc.), he settled down to a chronic psychotic state characterized by depression, hypochondria, paranoid delusions, and attacks of insane rage. Nearly two years after the beginning of his overt illness, when no improvement occurred, and when the psychiatrists in Rhodesia, where he lived, gave a hopeless prognosis, his son, who resided in London, brought him for psycho-analytical treatment.

His treatment with me lasted eighteen months. It was not, of course, a completed analysis, but it dealt sufficiently with the patient's outstanding problems to enable him to resume normal life and activity and to achieve for the first time in his life a feeling of stability and maturity. At the moment this paper is going to press, the patient has been back in Rhodesia for 18 months, enjoying good health and having resumed his business.

In his analysis I came to the conclusion that the unconscious fear of death, increasing with old age, had led to his psychotic breakdown. I believe that the same problem underlies many breakdowns in old age.

In a paper of this length I cannot give a complete picture of the patient's history or psychopathology, and I shall mention only such points as are relevant to my theme.2 He came from a little Ukrainian village, of an extremely poor orthodox Jewish family. His childhood was marked by fear of starvation and freezing during the long, cold winters. He had seven siblings, with nearly all of whom he was on bad terms. His mother was, to begin with, portrayed as greatly favouring his older brother, while he himself was a favourite of the father. In contrast to the mother, who was felt as cold and rejecting, the father was idolized, but also greatly fea