Problems of Development and Adaptation in an Elderly Patient

IT IS ON THE WHOLE ONLY RELATIVELY RECENTLY THAT PSYchoanalysts have overcome their reluctance to offer psychoanalytic treatment to patients over the age of 50. It was generally thought that older people were not suitable for analysis because they had become too set in their ways, had accumulated too much mental material over the years, and lacked the capacity for change. Gradually, however, an increasing number of analysts have begun to accept older analytic patients and many have been surprised at the favorable outcome of these analyses. It is true that quite a large proportion of the elderly patients who ask to see a psychoanalyst are people who benefitted earlier in their lives from analysis or analytic psychotherapy, but this is by no means true for all older patients who ask for help. This is particularly true of the group of elderly individuals who, reaching the last decades of their lives, come to the psychoanalyst suffering from depression, phobic or paranoid anxieties, crippling inhibitions, and severe problems around the regulation of self-esteem. These patients show from their life histories that they struggled with neurotic conflicts and character disturbances of varying magnitude, yet they also show that they have had the capacity for achievement and satisfaction in their lives. With internal and external psychological, social, and biological pressures imposed