Pollock G H
Int J Psychoanal. 1982;63(Pt 3):275-81.
In an aetiological perspective one has to consider the following in working with the older adult: antecedent psychopathology, situational crises that strain the ego's ability to maintain equilibrium, organic illness which can increase reactive symptoms. Age in and of itself need not preclude psychoanalytic treatment. In my successful work with middle aged and older adults, I have found: the capacity for insight, for therapeutically induced transferences for dreams and the ability to relate these dreams; the capacity for self-observation; the mobilization of motivation to change and also of libidinal and constructive aggressive energies; the institution of a mourning-liberation process. In the treatment situation, the elderly easily distinguish between the facade of interest and genuine caring and involvement on the part of the therapist. Older patients wish to be useful, and to preserve their dignity. Unlike younger patients, they do not fear death. At times they may welcome it as a relief from pain and anguish. The goal of psychoanalytic treatment is to make more of people available to themselves for present and future creative and satisfying life experiences. This can occur in individuals who are middle aged, older aged, or in the younger group of analysands.
从病因学角度来看，在治疗老年人时必须考虑以下几点：既往精神病理学、使自我维持平衡能力紧张的情境危机、可能增加反应性症状的器质性疾病。年龄本身并不妨碍精神分析治疗。在我对中年人和老年人的成功治疗中，我发现：洞察能力、治疗诱导的梦的移情能力以及关联这些梦的能力；自我观察能力；调动改变的动机以及力比多和建设性攻击能量的能力；启动哀悼解放过程。在治疗情境中，老年人很容易区分治疗师表面的兴趣和真正的关心与投入。老年患者希望有用，并维护自己的尊严。与年轻患者不同，他们不惧怕死亡。有时他们可能欢迎死亡，将其视为痛苦和折磨的解脱。精神分析治疗的目标是让更多人能够更好地面对当下和未来创造性且令人满足的生活体验。这在中年、老年个体或年轻分析对象群体中都可能发生。
