Introduction

This chapter starts by discussing the paucity of literature devoted to the psychodynamic treatment of older adults, although this population can benefit greatly from such treatment. It then examines the possible reasons for this avoidance. Challenges to the individual clinician are discussed, including painful countertransference, assaults to grandiosity, altered gratification from results, ageism, and unconscious normative processes. The biases of psychoanalytic institutes are also investigated. It is hypothesized that these biases can be traced in part to the history of traumatized psychoanalytic forbears. These led to technical rigidity, a devaluation of psychodynamic psychotherapy relative to psychoanalysis, and blind spots regarding issues, such as trauma, attachment, loss, mourning, and death anxiety. Psychodynamic psychotherapy can be very helpful to older adults, and this work can be rewarding to both clinician and patient. It is to be hoped that our field will expand its expertise and involvement with the population of older adults.