Psychodynamic Psychiatrists who Do Not Retire: Practice Wills and Patient Outcomes

In this issue of Psychodynamic Psychiatry, we publish the clinical article “Older Psychodynamic Psychiatrists: Practice Metrics and Subjective Observations,” by Douglas Ingram and Myron Glucksman. The authors queried in depth a convenience sample of 20 psychodynamic psychiatrists 65 years of age or older who were still actively practicing and reporting deep satisfaction. A similar unpublished study by Judith Kantrowitz of psychoanalysts in the same age group found high degrees of investment and engagement in their survey participants. The editors commend these carefully and vividly described studies. We note that more attention needs to be paid to outcome in longtime patients who lose their psychodynamic or psychoanalytic clinicians to illness or death, in alignment with the bioethical principles of beneficence and nonmaleficence. A professional will is recommended to all clinicians, not just those beginning at 65, since sudden, unexpected inability to work may affect psychodynamic psychiatrists and psychoanalytic clinicians at any age. Patients may for a variety of reasons be uniquely vulnerable to unresolved grief reactions or other negative sequelae from disruptions in this important care.