Academic journal article International Journal of Psychoanalysis

Growing Old: A Psychoanalyst's Point of View1

Academic journal article International Journal of Psychoanalysis

Growing Old: A Psychoanalyst's Point of View1

Article excerpt

With the help of clinical examples, the author shows that psychoanalysis or psychotherapy after the age of 70 can be a fascinating experience, one that enables patients to reconstruct their internal history in such a way that their final years can be given their rightful place in the overall journey through life. Often it will be a matter of going beyond the conflict between paralysing time with the illusion of keeping death at bay and taking the transient nature of life into account in order to perceive its true flavour. We can grow old passively, juxtaposing different periods of our life without linking them together, thereby creating the illusion of time without end; or we can grow old actively, integrating the different phases of our life into a coherent historical narrative. This representation of time leaves the door open for experiences which the author calls 'small seconds of eternity'. We can all experience such moments when we are deeply moved - joyfully or painfully - by something, so that we perceive another quality of time that goes beyond its chronological dimension without all the same negating it. Helping elderly people to identify these seconds of eternity and catch hold of them can be an invaluable experience for them. Perhaps we need to see our life unfold through the chronology of its different phases in order to discover, second by second, how to express on an everyday basis something of which we have had an inkling in some second of eternity.

Keywords: death anxiety, fantasy of eternity, fantasy of infinity, female sexuality and 'castration' anxiety, grandparents, internal life-history, mourning process, reintegrating memories, the 'blue note'

The psychoanalysis of an elderly person

I first became interested in the psychoanalysis and psychoanalytic psychotherapy of elderly people when a 70 year-old woman whom I shall call Berthe asked me to help her. She had requested an appointment because for many years she had been suffering from feelings of inferiority and depression. When I suggested psychoanalysis to her, she was at first surprised - "At my age? Out of the question!" - but then fairly quickly went on to say that she had been thinking about psychoanalysis for several years. Berthe therefore had psychoanalysis with me, on a four-session-per-week basis, for four years. The experience was a fascinating one and, when that analysis was over, several younger colleagues who were thinking of offering elderly patients either psychoanalytic psychotherapy or psychoanalysis asked me to supervise their work. I thereupon, inter alia, chaired a supervision seminar in psychotherapy for ten years in the Geneva geriatric hospital. Ten years after the end of her psychoanalysis, I met that former patient quite by chance at the opera; we chatted for a bit, and she told me that she was doing fine. Berthe was 84 years of age at that point, and she was just as lively then as when her analysis had come to a close.

I came to realize that, in psychoanalysis, the Oedipus complex is expressed with just as much vigour at 70 years of age as it is at 20 and that mental functioning in an elderly person is not fundamentally different from that of someone younger in years. That is why the basic technique employed by the psychoanalyst is, generally speaking, the same in both cases. There are the same basic references to the unconscious, the transference, the Oedipus complex with its genital and pregenital aspects, the compulsion to repeat, defence mechanisms, etc. In this paper, therefore, I shall not discuss these aspects which are common to all psychoanalyses and psychoanalytic psychotherapies whatever the patient's age.

I would nevertheless point out that the elderly patients whom I have had in analysis or whose analysis has been supervised by me do bring up certain specific issues. For example, their main conscious or unconscious motivation for seeking the help of a psychoanalyst is usually either a difficulty with mourning processes or their conscious or unconscious anxiety about dying, as Segal (1958) described in her seminal paper Fear of death: Notes on the analysis of an old man. …

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