ABSTRACT
Systematic research in psychotherapy is limited by the difficulties of applying theoretical concepts in ways that make it possible to measure them objectively. A review of the literature shows that psychotherapy with the elderly is not conducted often enough in relation to the apparent need for it; that there is no basis for therapeutic nihilism; and that there is no systematised body of theoretical knowledge about the psychopathology of late life that would serve as a scientific basis for rational treatment planning. Patients whose premorbid personality is characterised by versatility in adaptation tend to have relatively less psychological decompensation following age-related losses. The awareness of a loss produces the immediate response of anxiety or grief and mobilises specific defences, often precisely those whose continued operation is being threatened. An aggressive, ambitious person may try to defend against the threat of loss of control by becoming even more aggressive and controlling.
