Confrontations with Hopelessness: Psychoanalytic Treatment of the Older Woman*

The experience of hopelessness when treating the aging woman may reside more in the therapist than in the patient. In other words, when the therapist believes the patients is not treatable this idea may not be a comment on the patient but on the reactions of the therapist. This hypothetical orientation shapes my work with patients and is especially applicable to therapy with the aging patient, where issues of hopelessness frequently pervade the therapeutic relationship. This paper will examine a particular period in the case of Mrs. Z., who aroused much hopelessness in the therapist, and how that feeling was resolved in the course of the therapy.

A 63-year-old woman, Mrs. Z. came into therapy several years previous to the period of this study. She began treatment to deal with her inability to cope with her husbands's infidelity. Her husband, a successful lawyer in a New York firm, announced he had been having a 6-year affair with a colleague whom he wanted to marry. That crisis in their life was resolved by the husband's serious depression when he tried to leave his wife, and his subsequent decision to remain and to give up the “other woman.” Mrs. Z. came into treatment two years after this shock, from which she had never recovered. She selected a female therapist to understand her and also to help explain men to her. Mrs. Z seemed to want a therapist who was like her in many ways. She had been referred by the huband's psychiatrist, with the request that I also consider marital counseling for the couple.

The approach in which I work derives from the theoretical perspective