ZOYA, L. (Milano). ‘La terapia analitica di fronte alla vecchaia’ (Analytical therapy in old age). Psicogeriatria. Milan,  Edizioni Masson (1979, in press).

In this challenging paper Zoya describes the situation of old people in Western society, where their numbers are ever-increasing but the respect and status formerly accorded the accumulated experience of a lifetime are denied them. Furthermore, old age is no longer regarded as the last chapter of a healthy life but as an ‘illness’, almost everyone now eventually finding himself a patient in hospital, where modern medicine staves off the inevitable outcome and modern attitudes decree that it must not be mentioned. Until early this century, the end of life was invested with meaning and surrounded by ritual; last words—an allegory of the transmission of the pneuma—were considered sacred and conferred value upon the humblest individual, but today the dying and mourners alike are robbed of such recognition by the prevailing and unprecedented taboo on death.

These depressing circumstances might lead one to expect older patients would form a large part of every analytic practice but, as Zoya points out, the reverse is the case. He knows many analysts who refuse patients over forty on the grounds that psychic structure after that age is too rigid for modification, maintaining that the only suitable treatment is supportive psychotherapy restricted to clarification of conscious contents. Zoya refutes this with the pertinent observation that analysis aims at analysing and not at modifying psychic structure, and that it is precisely clarification of conscious contents which is of little avail in the face of set ways of thought and possible intellectual deterioration. In his experience, the transference develops better with a patient old enough to be his grandparent than with a young one, the image of the Old Wise Man being readily projected on him. He stresses the importance, in these cases, of totally accepting the projection and of treating the patient with particular respect, likening the relationship to that between Virgil and Dante journeying in search of understanding and