Psychoanalysis of the older patient

A small informal poll of local colleagues revealed that despite their interest in the subject, many had doubts about the possibility of analyzing persons aged sixty or over successfully. Their specific questions are collated and are offered as a sample of the questions in the minds of many analysts everywhere. Selected material from the ongoing analysis of a sixty-four-year-old patient is presented that bears on some of the questions raised. In addition, changes in the patient are noted. These are discussed in terms of changes in function, which are equated with structural change. The major thrust of the paper is that development continues throughout the life course, and that the criteria for analyzability remain constant. The chronological age of the adult by itself is not an indicator of eligibility or of suitability for psychoanalysis.     

Spatial location judgments as a function of intention to learn, and mood state: an evaluation of an alleged automatic encoding operation

An assessment of the Hasher and Zacks (1979) conceptualization of the automatic nature of the acquisition of spatial location information was made in the context of manipulations of subjects' intention to learn and mood state. The Velten (1968) mood induction procedure was used to establish depressed and nondepressed subjects. Half of each group was then presented with a matrix of geometric forms under instructions to learn the location of the forms (intentional) or to evaluate the pleasantness of the array (incidental). Subsequent tests of spatial location performance found no differences as a function of subjects' mood state, but did find a strong effect for instructional condition. The superior performance of the intentional subjects raises questions about the automatic nature of the encoding of spatial location.     

Determinants of object choice in adulthood: a test case of object-relations theory

A clinical example of the effects of the absence of the father during the early childhood of a male analysand and its consequences for his later object choice is presented. This patient's biological father left the household when the patient was only a few months old, and his mother did not remarry until he was five years of age. Unconscious fantasies of the lost father, with whom the patient had no contact in reality, and longing for him organized the patient's drives and determined his self-identity as well as his later object choice. The patient developed both a positive and negative identification with the lost father. The identification was with a fantasy object not a real one. The case highlights the need to use a precise term in talking of the object, namely the mental representation of the object which may or may not be built up out of experiences with the real object.     

Superego formation, adolescent transformation, and the adult neurosis

The superego is heir to the Oedipus complex but has a much larger developmental legacy which includes preoedipal precursors and the influence of latency and adolescence. The superego continues to change in function and content throughout life, and radical transformation in adolescence may result in developmental discontinuity as well as core developmental continuity. A case is discussed in which adolescence was overlooked in previous analysis and in which adolescent superego modification had a major impact on the patient's character and his adult neurosis. The developmental significance of adolescence experienced under conditions of social isolation and rejection with forebodings of the Holocaust was unrecognized in sanctioned silence and shared analytic denial. These repeated earlier experiences of silent submission and stifled protest, and the silent suffering of the patient and his family, were an integral part of his humiliating and emasculating adolescent experiences. The intimidated adolescent, threatened from within and without, identified with the aggressor as well as with the victim. Identification with the aggressor and glorified victor contributed to a final adolescent structuralization of a punitive, sadistic superego and a rigidly perfectionistic ego ideal. As an adult, he tended to passive masochistic compliance with diminished self-esteem and unconscious self-denigration. He was prone to shame and guilt, self-criticism, and hidden hypercritical attitudes toward others. The adolescent internalization of aggression, intense castration anxiety, and pervasive narcissistic mortification led to retreat from resolution of revived oedipal conflict and to concomitant detrimental superego alteration. These issues were of major importance for analytic understanding and therapeutic progress.