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The stimulus for this paper was the analyst's surprise at the capacity for change in a number of middle-aged patients, some of whom would not have been considered good analytic prospects even if young, especially since they had all had extensive, unsuccessful previous psychiatric and psychoanalytic treatment, in two instances with the author herself.
Factors of change in what now constitutes “old age,” and of analyzability, rigidity, motivation and readiness for change, countertransference factors, and the significance of a late-appearing corrective emotional experience were all considered, along with a brief re-evaluation of what the analytic process really is, and how change comes about.
In considering psychoanalysis and middle age, I am not dealing with anything that has come to be known as “mid-life crisis.” What I intend to talk about is psychoanalytic treatment in late mid-life. In recent years, a growing sense of surprise has thrust itself into my awareness — at the analyzability, and the capacity for change, in older people. Perhaps the growth of geriatric psychiatry has played a part in this — I do not think so, since to me it implies primarily appropriate supportive care. Perhaps a greater number of older people come for treatment these days; no doubt there are other factors at work as well.