Meeting of the New York Psychoanalytic Society

January 13, 1976. ON THE POSSIBLE EFFECTS OF AGING ON THE PRACTICE OF PSYCHOANALYSIS. K. R. Eissler, M.D.

The author discussed the psychological effects of growing old upon the psychoanalyst and his working relations with his patients.

Aging produces an accretion of narcissism. If it concentrates within the superego or ego-ideal, the analyst becomes more rigid, compulsive, and intolerant in his practice (and subject to involutional depression). If the narcissistic accretion concentrates in the analyst's ego, he will expect the patient's admiration, awe, and respect. Obviously, both attitudes will interfere with the patient's analytic work and the analyzability of his transference. If, however, the narcissistic accretion is evenly distributed over the personality (and aided by diminution of id pressure and thus, of conflict), superego and ego will be more harmonious. This will allow the analyst greater toleration of the patient's illness, reduce therapeutic ambition, and produce greater acceptance of the patient's humanity.

Aging decreases a tendency toward activity and increases desire for knowledge and insight. This brings about a more proper analytic stance toward the patient's resistances—particularly when successful analysis reaches a deep paranoid level in the patient. As aging produces increased recall of childhood, the aging analyst may have more empathy for the childhood of the patient as it returns in the analysis.

With aging, death becomes a problem of life. If the analyst has integrated death as a necessity, he will be able to handle inevitability as a factor in the patient's life and will also be better able to help the patient analyze his or her death wishes and fears. However, one should be careful about appearing too heroic to the patient, as this reduces self-esteem and provokes guilt reactions. The death of contemporaries comes with aging. This may lead to a greater investment in the patients, which may or may not be beneficial to the quali