In an aetiological perspective one has to consider the following in working with the older adult: antecedent psychopathology, situational crises that strain the ego's ability to maintain equilibrium, organic illness which can increase reactive symptoms.

Age in and of itself need not preclude psychoanalytic treatment. In my successful work with middle aged and older adults, I have found: the capacity for insight, for therapeutically induced transferences for dreams and the ability to relate these dreams; the capacity for self-observation; the mobilization of motivation to change and also of libidinal and constructive aggressive energies; the institution of a mourning-liberation process.