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This short book reports on the experience of psychoanalytic psychotherapy with patients of over 65 years in the Tavistock Clinic unit led by Peter Hildebrand in the late nineteen seventies and eighties. Hildebrand reviews the history of psychotherapy provision since Freud's time. Influenced perhaps by Freud's view that by 50 years defences were impervious to modification by psychoanalysis, and by the belief in most training institutes that 40 years was the upper age limit for candidates’ entry for training, there was very little experience and very little written on what Hildebrand, and before him Adam Limentani, called the Third Age.
This book is largely based on clinical work in a National Health Service clinic. Having challenged the view that creativity diminishes with age (rebutted by the lives of many writers, poets and artists and by the life of Freud himself), Hildebrand looks briefly at the development stages from adolescence onwards, including the phenomenon of ageism, retirement and of the rapid growth of the Third Age population because of improvements in the standard of living and the dramatic advances in medical treatments. Life expectancy has increased by more than ten years in the past half century and is likely to increase by at least another ten years by 2015. With these changes, there is a need to rethink the former tendency to discard the old into institutions where care was often lacking and where neglect and abuse often went undetected.
Hildebrand then examines some major life situations and the way they are affected by the ageing process. These include sexuality, work, marriage, cognition, death and loss. Under these headings he outlines the realities of growing old, including loss of powers, of status and authority, of health, of sexual potency, of unfulfilled goals and ambitions, and loss of friends and loved ones. Overshadowing all is the fear of death itself. He looks closely at the issue of failing memory, which might in the past have seemed