ABSTRACT
This chapter focuses on existential issues which may cause distress in older adults, contributing to their symptoms. Three existential tasks are identified. The first, is the transition of death from an intellectualized concept to a felt experience. Help for this task is provided by (1) psychotherapeutic exploration of feelings, fears, experience of and fantasies of death, (2) identifying the way early trauma infiltrates fantasies of death, and (3) finding ways to bear the powerful related affects. The second task is the search for meaning. As patients identify their unique ways of engaging life to provide meaning, psychotherapy helps by strengthening the capacities which foster their attempts. The third task is accepting one’s lack of omnipotence by finding ways to surrender to the inevitable while retaining agency. The challenges this work presents to psychotherapists, who face their own existential anxieties, is discussed, and clinical examples are provided.
