ABSTRACT
This chapter considers the problems of the therapist who faces her hatred of the patient and her own weariness, leading to her barely acknowledged wish to end the therapy. The therapist grows old and tired, both literally and metaphorically, and should accept that this may need to be recognised. Therapists often find it difficult to tolerate the ways in which their patients are receiving something that they want themselves. While older therapists may contribute to the therapy of their older patients from the wealth of their experience, they also have to consider the realities of old age. Therapists have to balance their own understanding of their fitness to practise and weigh that against their agreement to work with the patient. The therapist must give up her manic defence if she has any reason to think that she is no longer helpful to her patients.
