Human Development: Aging

Adult Psychoanalytic Training (APT)
2021-22, 2nd Trimester — Fridays, 1:45-3:15pm
Píyale Cömert, PhD
Rebecca Meredith, MA


Introduction

Welcome to our seminar on Aging. When we meet, we would like to discuss our goals and objectives, find out yours, and mold the course to get the most out of our class time.

Content of the Course

We are looking forward to the course. Mainly we’d like to focus on the joys and fears of working with the elderly. We have found that much of the literature focuses on our feelings about facing our own transience and mortality.  Several of the authors have been quite revealing in what for them constitutes the keys to being able to face one’s own and or another’s transience (be it facing a loss, change, retirement, death or death of a loved person or patient) with peace, integrity, and equanimity.

We have tried to select articles from the last 10 years from a variety of different theoretical viewpoints and on a number of different topics. Although “aging” itself is considered as a type of diversity we looked for articles on other dimensions of diversity but were minimally successful.

We’d like to approach each topic with an emphasis on our own feelings evoked by the topic, article, or issue. As much as possible, we hope that we all bring in our own clinical material, reactions, thinking.

Our interest is to allow us to develop and expand our sense of what it means to be working with an older population. What are the primary concerns of the elderly? What are the major obstacles in our working with them? What are the benefits and joys of being with them? What questions come to mind? Does our usual way of thinking about development fit or are there better models? How can we grow in working with the elderly? What does the transference and countertransference look like? How does culture, race, disability etc. affect our patients and our own attitudes toward the elderly? What is mutative in working with this population? We are equally interested in considering our own reactions to aging and ultimately our own death. Our aim is to have us expand our own vision of what it means to be an elderly analyst and to be an analyst to the elderly.

The Process of the Course

As always, our group process is key. We would like us all to pay attention to creating an atmosphere of safety. We want us to build a space for optimal, intimate, personal, emotional, and intellectual exchange. We would like to remind us all about confidentiality concerning clinical material discussed.

We would like to ground the course in the emotional moments between you and the person with whom you are working and/or your emotional response to the readings. We hope you will let us know what articles were helpful, useful, deepening of your thinking and which were not. Please feel free to challenge and critique anything you read or we or anyone says.

We would like to divide responsibility for the articles among the group. In a few sentences (elevator pitch), what are the key take away points of the article? And we mean elevator pitch—not a long drawn out summary of the article, which can be hard to attend to. One or two sentences would suffice. Beyond that here are some other possible items to consider:

  • What are one or two key questions that the article raised?
  • What was your response to the article? Did it bring up anxiety? Delight?
  • Did it bring up clinical examples?
  • Did it bring up personal reflections?

Poems:To facilitate our self-reflection and prepare us for the discussion of the articles, we decided to make use of poetry. The syllabus below includes the poem that is paired with each class meeting. Please read the poem before coming to class. One of us will read the poem out loud at the beginning of each class meeting and we will spend a few minutes discussing our reactions to it before transitioning to the discussion of the articles and any relevant clinical material.

Learning Objectives

Our overall learning objectives are to:

  1. enable clinical associates to cite one aspect of countertransference that is different in working with elderly patients than younger patients
  2. name three modes of protecting ourselves from facing one’s transience and three affective experiences we defend against
  3. describe or imagine one aspect of being an elderly analyst either working, retiring, or dealing with illness
  4. name three new pieces of information about various aspects of aging, including the experience of aging in diverse populations

Clinical Impact of the Knowledge or Skills Gained

Clinical Associates will:

  1. have a greater ability to name, tolerate, and put into perspective their patients, and their own, defenses against and feelings about their own mortality
  2. be able to face their own mortality with a greater sense of peace and tranquility
  3. open themselves to the satisfactions and joys of working with the elderly and do so more often
  4. enact more creative responses to aging

December 3, 2021 — Perception

Richeson, J.A. & Shelton, J.N. (2006) A Social Psychological Perspective on the Stigmatization of Older Adults. In: National Research Council (US) Committee on Aging Frontiers in Social Psychology, Personality, and Adult Developmental Psychology; Carstensen LL, Hartel CR, editors. When I’m 64. Washington (DC): National Academies Press (US)

Zitter, J.N. (2019) The lifelong mistreatment of black patients. The New York Times, June 29, 2019, 5.

In-Class short video (Progressive commercial) and song (“Hello in There”)

December 10, 2021 — Adaptation at Midlife

[31 pages]

Strenger, C. (2009) Paring down life to the essentials: An epicurean psychodynamics of midlife change. Psychoanalytic Psychology, 26:246-258.

Kolod, S. (2009) Menopause and sexuality. Contemporary Psychoanalysis, 45:26-43.

Poem: “The Poem of Age 35” by Cahit Sitki Taranci

January 7, 2022 — The Analyst’s Illness

[13 pages]

Kaplan, A. (2017) Man on wire: Walking the therapeutically transformative tightrope of the analyst’s cancer. Psychoanalytic Dialogues, 27:218-226.

Buechler, S. (2017) When the analyst suffers illness and loss. Psychoanalytic Dialogues, 27:237-240.

Poem: “Do Not Go Gentle Into That Good Night” by Dylan Thomas

January 14, 2022 — Cognitive Decline

[16 pages]

Case Presentation: Piyale Cömert.

Mid-term evaluations should be conducted in the closing minutes of your classes today. This is a discussion that should be allowed at least 10 minutes, but no more than 30 minutes. No written records are necessary.

Midterm Class Evaluation Discussion Questions

Sherman-Meyer, C. (2016) Swimming lessons: Aging, dissociation, and embodied resonance. Psychoanalytic Perspectives, 13, 201-213.

Pines, D. (2014) Stroke and the fracturing of the self: Rebuilding a life and a practice. In Clinical Implications of the Psychoanalyst’s Life Experience. Ed. S.  Kuchuck, New York: Routledge, pp234-236.

Poem: “Forgetfulness” by Billy Collins

 

January 21, 2022 — Working With a Dying Patient

[64 pages]

Allan, M. (2017) Working with a dying patient and the power of the patient analyst bond. Psychoanalysis, Self and Context, 12:131-143.

Gawande, A. (2014). “Letting go” in Being Mortal, Medicine and What Matters in the End. New York: Henry Holt and Company. pp149-190.

Segal, L. (2014) Temporal vertigo: The paradoxes of aging. Studies in Gender and Sexuality, 15, 214-222.

Poem: “In View of the Fact” by A. R. Ammons

January 28, 2022 — Remaining Creative in Old Age

[13 pages]

McWilliams, N. (2017). Psychoanalytic reflections on limitation: Aging, dying, generativity, and renewal. Psychoanalytic Psychology, 14, 50-57.

Bergmann, M.S. (2014). “Psychoanalysis in old age: The patient and the analyst” in Clinical Implications of the Psychoanalyst’s Life Experience. Ed. S.  Kuchuck, New York: Routledge, pp237-241.

Poem: “Matisse, Too” by Alicia Ostriker

February 4, 2022 — Old Age as a Discreet Developmental Stage

[31 pages]

Chodorow, N.J. (2018). Love, respect, and being centered Upon: Loewald’s image of development in childhood and the consulting room. The Psychoanalytic Study of the Child, 71:224-233.

Rizzolo, G.S. (2019) The life cycle (without regression). The Psychoanalytic Study of the Child, 72:207-227.

Poem: “There is a Girl Inside” by Lucille Clifton

February 25, 2022 — How Do We Change as an Analyst as We Age?

[27 pages]

Slochower, J. (2019) Getting Better All the Time? Psychoanalytic Dialogues, 29:548-559.

Junkers, G. (2013) Later, perhaps… Transience and its significance for the psychoanalyst. In The Empty Couch: The Taboo of Ageing and Retirement in Psychoanalysis. Ed. G. Junkers, New York: Routledge, 17-31.

Poem: “The Summer Day” by Mary Oliver