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It is hard to know where the middle years start and end, but generally the onset and end increase with the age of informant. There does come a time, however, when it is hard to think of one's self as “young.”
For many years, psychoanalysis tended to confine its treatment to the relatively young adult and children, this perhaps having to do with some grandiose notion that we could change the lives of future generations. We now recognize that psychoanalytic insights can be of use to older people, the physically ill, and the dying. To deal with these people we must recognize aging, illness and death as possibilities in our own lives.
This first happened to me when I was referred a 32-year-old woman who was rapidly dying of cancer. She was married, had a five-year-old daughter and recently had had an abortion because of the cancer. (Dahlberg, 1974.) At that time I was working with LSD, which had a reputation as being effective with the terminally ill, not only as a good analgesic but, more importantly, as allowing a person to cut through defenses and feel more deeply and accept death. This woman had heard about this work and wanted to “talk straight” to someone. It was a tragic case, and I spent five hours in one day with her. Her main defensive was a sarcastic, “It doesn't matter to me that I'm dying,” and during our session she discovered that it did matter and that she was not suicidal, as she had thought. This discovery allowed her to die more peacefully and accept help without bitterness as her strength flagged.
The effect of this session upon me was quite startling. I think I handled it well and put down my fatigue, the evening of the five-hour session, to the stress of an emotional and overly long session. I was alerted to my countertransference response by a series of