Empathic attunement is the bedrock of self psychological treatment. In the treatment of midlifers who show underlying narcissistic vulnerability, achieving such empathy is sometimes more difficult that one might imagine, particularly since therapists, who are midlifers themselves, are often vulnerable to the impact of midlife stresses. Potential stumbling blocks may arise that stem from therapists' identification with and anxiety about patients' struggles that are similar to their own; difficulties relating to patients' problems that seem unfamiliar or alien; and assaults to therapists' own sense of self or selfobject needs.