Wylie, H.W., Jr. Wylie, M.L. (1987). The Older Analysand: Countertransference Issues in Psychoanalysis. Int. J. Psycho-Anal., 68:343-352.

(1987). International Journal of Psycho-Analysis, 68:343-352

The Older Analysand: Countertransference Issues in Psychoanalysis

Harold W. Wylie, Jr. and Mavis L. Wylie
Because psychoanalytic training takes so long, by the time the majority of candidates become practising analysts and thoroughly
experienced in the techniques of their art, they are sufficiently into middle age to be classified as 'older' rather than 'younger'. Yet, one
rarely hears analysts refer to analysands as old as or older than themselves. This may be in part due to that small proportion of the
population in their fifth, sixth and seventh decades which comes for psychoanalytic treatment. However, contributing to this, we feel,
has been an unexamined acceptance by analysts of the notion that decrements associated with age make psychoanalytic treatment for
older persons unfeasible. Such an unsubstantiated assumption should alert our attention to the possible intrusion of unacknowledged
countertransference issues connected with the consideration of analytic treatment for older patients.
Since we do not know the relationship of age (in an upward direction) to analysability, it raises the interesting question of whether
and at what point age alone, barring organic impediment, renders a patient unsuitable for psychoanalysis. To this end a fruitful line of
inquiry would be to study the outcome of analyses of older analysands who had previously had an intensive analytic experience as
compared to the outcome of those older patients who had had no prior analysis, but were analysed for the first time as an 'older'
patient. This might help clarify whether, for example, age affects the individual's capacity to 'learn' how to think 'analytically' and
engage in an analytic process. In the absence of such studies and their confirming (or disconfirming) data however, we might ask if
there is not an unsuitable contradiction in the thinking of practising psychoanalysts that permits on the one hand their agreement that
the analyst's self-analysis is a timeless and essential necessity in maintaining the required neutrality and flexibility in psychoanalytic
work, but on the other hand demonstrates so little expectation of the same adaptability and flexibility in the prospective analysand
above a certain age, regardless of sex.
For the roots of some of these notions we do not have to look beyond the originator of our science. Freud was pessimistic about
the liability of age regarding psychoanalytic treatment.
On the one hand near or above the age of fifty the elasticity of the mental processes, on which the treatment depends, is
as a rule lacking—old people are no longer educable—and, on the other hand, the mass of material to be dealt with
would prolong the duration of the treatment indefinitely (Freud, 1905p. 264).
In 1933, he identified the effects of age which he felt constituted a particular interference in the treatment of women.
A man of about thirty strikes us as a youthful, somewhat unformed individual, whom we expect to make powerful use
of the possibilities for development opened up to him by analysis. A woman of the same age, however, often frightens
us by her psychical rigidity and unchangeability (Freud, 1933p. 134).
Since the majority of psychoanalytic practitioners today are over 50 years of age, Freud's statements about the inelasticity of the
mental apparatus and the ineducability of those past 50
—————————————
Presented at the 34th International Psycho-Analytical Congress, Hamburg, July 1985.
(MS. received April 1985)
(Revised MS. received January 1986)
Copyright © Institute of Psycho-Analysis, London
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might give cause for concern were analysts to accept this thinking for themselves as they so readily assume it for their patients.
Fortunately imbedded in Freud's recommendation for self-analysis are indications regarding a view of development that allows us to
chart a course around this seeming contradiction. Freud's belief that self-analysis permits a continued restructuring vis à vis 'all
subsequent experiences' clearly negates a time limited concept of psychological development.
We reckon on the stimuli … received in his own analysis not ceasing when it ends and on the processes of remodelling
the ego continuing spontaneously in the analysed subject and making use of all subsequent experiences in this newly-
acquired sense … (Freud, 1937p. 249).
Self analysis is traditionally advocated for prophylactic purposes. The psychoanalyst is aware that 'unconscious conflicts lower the
quality of his work [and] provides an obligation for self-analysis' (Ticho, 1967p. 316) and this explains why there is no greater
consensus among analysts than on the need for continuing self-investigation. However, Freud underscored a more advantageous
enhancing function of self-analysis. And if we borrow from Erikson's epigenetic theory the hypothesis that libidinal and ego
development spans the whole life cycle in a sequence of phase developmental tasks (Erikson, 1959), we can conceptualize Freud's
1937 recommendation for self-analysis not only in preventative terms, but as the opportunity to facilitate and maximize continued
growth. As Ticho articulately reaffirmed:
If the analyst can convey to his patient that their mutual task consists predominantly in removing obstacles which
prevented the patient from making the fullest use of his own potential for further growth and to reclaim for constructive
activities the energy previously tied up in neurotic security measures, then the analysand will want to continue this
never-ending process (Ticho, 1967p. 312).
Loewald (1979) observed that the working through of the conflicts which comprise the oedipal complex is, in fact, a life long re-
working through process. In terms of an individual's life cycle, this implies that the mastery of tasks at each specific phase requires a
re-confrontation with the conflicts contained within the nuclear oedipal complex (whether these tasks concern marriage, parenthood,
re-marriage, illness, death, retirement, or the meaning of one's own approaching death). Thus each phase confronts the individual with
the choice of making further progress towards resolution by re-working again those oedipal issues central to personality development,
or of regressing to its alternatives; repression, denial, depression, rigidity. The choice that is tendered is not always obvious and is
never easy. (As Freud cautioned Rank fifty years ago, 'How strong … the desire to get away from the Oedipus whenever there is a
chance' (Freud, E.L., 1975p. 358)'
Although to date there has been a most unanalytic restriction on the range of investigations concerning the psychoanalysis of the
older patient, Pearl King (1974), (1980) has been among the handful who have explored some of the countertransference issues. She
has focused attention on the analyst's tendency to equate the older patient with his or her parent.
The affects, whether positive or negative, that may accompany transference phenomena are often very intense with
older patients, and they may arouse unacceptable feelings in the analyst towards his own ageing parents (King, 1980p.
159).
Abraham identified the same countertransference distortion, stating:
[It] places the therapist in the position of the child with respect to a weakened parent in need of help (Abraham et al.,
1980p. 151).
He then pointed to the jeopardy in which this places patient and therapist, if left unanalysed.
This induces in the therapist the fear of his own potential aggressiveness which might, although repressed and latent,
escape his control (p. 151).
This requires, according to King:
those undertaking the psychoanalysis of such patients to have come to terms with their own feelings about their own
parents and to have accepted in a healthy, self-integrative way, their own stage in their life cycle and their own ageing
process (King 1980p. 159).
In the event of an analyst's not 'coming to terms', King predicts the likely result will be the
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analyst's self deceptive assumption (in reality the analyst's projection) that the older patient would be unwilling to trust one obviously
younger than the analyst when considering psychoanalytic treatment.
Equally important is another unsubstantiated hypothesis about the analytic potential of the older patient that has achieved
consensual (but not clinical) validation and is generally omitted from consideration as a possible countertransference distortion.
Namely, the nature of the conflicts of the older patient. In the literature it has been presumed that the conflicts to be worked with in the
older patient are of a different order than those of the younger patient. Abraham, for example, attributed neurosis in the elderly,
essentially to conflict between the ego and the ego ideal (Abraham et al, 1980). In doing so he overlooked the possibility that what he
observed was not the cause, but the result of a failure of the individual to rework nuclear oedipal conflicts remobilized by
confrontation with developmental demands pertinent to that life stage (Loewald, 1979). The tendency to assume theoretically that those
of 50, 60, 70 and upwards do not also suffer conflict between drive and defence represents a not-so-subtle form of unanalysed
countertransference masquerading as ageism. Balint illustrates this proclivity to devalue the concept of drive conflict in the ageing by
focusing exclusively on the return to a more infantile level of sexuality as a retreat from the inevitable narcissistic injuries associated
with the spectrum of losses in this phase of development. He argues that:
We know that it is this genitality which ceases in old age. It is theoretically probable that this complicated organisation
[genital sexuality] resolves itself into its component parts, which then assume great importance as previously in
childhood (Balint, 1933p. 74).
Balint has described a libidinal regression as the dependent variable of ageing. We believe it would perhaps be more accurate and
more useful to consider regression as an independent variable. Although regression may occur in response to the anxiety of separation
and the fear or experience of loss common to this age group, regression just as frequently may occur as the consequence of anxieties
associated with oedipal level conflicts mobilized by these age-specific developmental hurdles. These are the same regressive obstacles
that prevent us throughout life from making the fullest use of our potential for growth. Phenomena such as Balint describes would
certainly interfere with the psychoanalytic work of patients of any age. To assume the inevitability, the excessiveness and/or the
intractability of such regression in older patients is not only to deny the older patient his or her humanity but reifies projected fears of
the analyst regarding limitations for his own continued development.
Pollock's 1982 essay, 'On ageing and psychopathology', supplies us with a most useful definition of psychoanalysis. It addresses
indications for analysis across the board, irrespective of age, not merely when the analysand happens to be the practising analyst
working to maintain mastery of his inner life:
We all know that psychoanalysis is a humanizing force which allows an individual to be in touch with parts of himself
or herself that have been forgotten, neglected, or pushed away and yet continue to exert important influences upon the
individual. During analysis these parts become alive, old emotional allegiances are revived, passions and rages re-
awakened – paths overgrown walked upon anew (Pollock, 1982p. 279).
The clinical material that follows is a report of the analysis of a woman who began treatment at the end of her sixth decade with
an analyst 15 years her junior. A brief history of the patient is given. This is followed by an evaluation of analysability, a
characterization of the transference and countertransference configurations which emerged and a summary of the analysand's self
analysing capacity in the termination phase. To the satisfaction of both the analyst and the analysand, the analysis was completed seven
years after it began.

BACKGROUND AND HISTORY

J came for analysis: a senior partner in a prominent law firm, actively involved in practice. She had achieved a distinguished
reputation for herself from a long and successful legal career. The coincidence of two events
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precipitated J's entry into treatment; the death of a close friend and the appointment to the Federal bench of a junior colleague whom J
had previously championed as a person of great promise. J unexpectedly felt herself cast into a state of confusion and turmoil which
touched directly upon fears that she might not achieve her life goals. This mobilized anxiety about aspects of her ageing and the
possibility of eventual over-dependence on others. Becoming concerned that her work was stagnating, J felt increasingly non-
productive. She viewed her social life in a similarly bleak and diminished fashion.
J's husband had died several years before the analysis began. A man some years her senior, J had loved him deeply despite their
philosophical differences. She described him as a brilliant, intellectual enfant terrible. They had been married only a few years
however, when he suffered a myocardial infarction and died shortly afterwards. There were no children.
J was the second and only girl of 3 siblings 'spaced' roughly two years apart. J remembered her mother as a beautiful energetic
woman who dressed fashionably, drove expensive cars and managed a large house with ample servants. She was attentive to her
children's appearance and took pleasure in dressing them attractively. J recalls that her mother seemed especially to enjoy teasing her
sons with seductive comments.
J described her father as a remote, handsome figure of a man, a disappointing breaker of promises who took little interest in his
children. J's most vivid memory of him was of his angry response to her when she took a modelling job as a teenager. An attractive
adolescent, she was cognizant of the interest and envy she inspired in her mother, but was surprised, yet gratified at her father's
indignation at this job, for it indicated to J that, in fact, he was interested in her.
Before her birth, J's father had established a flourishing business. J believed that while her father's flair had got the business
'going', it was her mother's pragmatic vigilance that made it a consistent success. For example, throughout her childhood J's father
periodically used funds from the business in pursuit of indulgences that threatened its stability. Each time however, his dash and
business acumen strongly supported by her mother's resourcefulness managed to restore the business to its prosperous state.
Though J described herself as not a particularly good student, she graduated from a local college and received provisional
acceptance in a law school located a considerable distance from her home. Departure for law school was her first major separation
from her family. The assault of that experience which coincided with a number of highly disruptive, situational factors precipitated her
decision to abandon law school during the first month.
An especially terrifying nightmare that occurred just after this abortive attempt to separate from her family (the memory of which
lingered disturbingly) persuaded J to consult a well known psychoanalyst upon her return home. She saw him twelve to fifteen times
over a three month interval and found the period of psychotherapy richly constructive. Although the psychoanalyst's recommendation
that she enter analysis at that time felt too overwhelming, she perceived that he had assisted her in understanding the relationship of the
precipitating nightmare to her fears that she had lost control over her life. She thought the therapy had also enabled her subsequently to
move out of her family's home, to become productively and successfully engaged in work and to assume an active and satisfactory
sexual life. Although she was not at this time interested in establishing a long term relationship with a man, J described herself as
enjoying the company of men and taking pleasure in an awareness of her attractiveness to them.
A short while later J re-entered law school and completed the required work in an outstanding fashion. Upon graduation, she
commenced her professional career.
About this time, her relationship with her mother became more conflicted. Her father had died after a period of invalidism brought
on by his refusual to accept treatment for a highly treatable condition. In order to gain some understanding of these changes in her
relationship with her mother, J again entered psychotherapy, the duration of which extended intermittently over the next half decade.
When J's mother became ill (dying a few years after the death of J's husband). J assumed the bulk of the responsibility for her
mother's
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care. She felt that in doing so, she had lived out her father's prophetic opinion that she (J) was the most responsible of his children.

ANALYSABILITY
These were the background data upon which the evaluation of J's analysability was based. In determining the patient's suitability
for analysis and her potential for establishing a good analytic relationship, four factors in particular were weighed in addition to
considering the pertinence of her unselfconscious, direct manner. (1) Motivation: J was aware of the infrequency of psychoanalysis in
her age group. Having had useful, but limited success with psychotherapy in the past, she wanted to try analysis to see if she could
effect further change. (2) Psychological mindedness: J was curious about herself. Her self-observing questions about her own
motivation gave an impression of flexibility and allowance for change. (3) Intelligence: J was highly verbal and intelligent. In addition,
it appeared she would bring to an analysis not only a history of highly organized aggressive thinking, but a keen, though covert, sense
of humour as well. (4) A history of long standing relationships: Together with a capacity for maintaining durable relationships, J
conveyed the sense that she possessed an availability for establishing new relationships. The analyst, in short, sensed that they would
'hit it off'.

THE ANALYSIS
In the first half of the analysis, although highly motivated to change, J found it difficult to accept that the analysis was not directed
primarily towards therapeutic benefit (i.e. symptom relief), but was focused on conflict resolution. Her analysing capacity was initially
quite limited in its range; its autonomy particularly comprised when material related to the transference threatened to emerge into
consciousness. For example, when the analyst was absent, J was reluctant to think about him and denied fantasies as to his activities
and whereabouts.
During the first three years, the analysis was characterized by intense dyadic transference configurations that were idealizing and
erotic. At this point in the analysis, the potency of the pregenital drives was striking. The similarity of J's verbalizations with those of a
patient thirty years younger was remarkable. Here the utility of the couch became abundantly clear in promoting countertransference
analysis. In order to midwife the regressive fantasies of the patient, the analyst needed to be able to allow his mind to explore
comfortably the thoughts of an older woman relating to him in the context of an erotic transference at all libidinal levels. Unanalysed,
his oedipal taboos (mobilized by the analysand's chronological age and appearance) might have threatened and interfered with the
analyst's free and wide ranging empathic attention to the transference wishes of this older female patient. The couch, by removing the
impediment of visual cues, facilitated the analyst's self-analysing process. Pearl King (1980) has correctly drawn attention to the
analyst's defences against the mobilization of aggressive conflicts concerning older patients identified with the analyst's parents. We
would suggest that the analyst's defences against sexual conflicts mobilized by the older patient who becomes identified with the
analyst's opposite sex parent present an equally important source of countertransference difficulty.
In the first half of the analysis, J relied on three particular forms of resistance: somatization, acting out, reaction formation.
Towards the first of these defences, the analyst found himself questioning whether the neutrality of the analytic position was too
demanding in the case of a woman at whose age certain physical problems appeared to be a legitimate interference. After analysing the
countertransference implications of this, the analyst was able to assist the patient in exploring the resistance implications of her
somatizations. The result was seen in the expansion of J's originally nascent, but subsequently vigorous and substantial capacity for
self-observation and sublimation.
Midway through the second year when the analyst moved his office and raised his fee, J experienced these changes both as a
rejection and a diminution of her value in his eyes and were strongly reminiscent of early maternal experiences now being relived in
the transference. At
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first unable to analyse the affects that were mobilized, J's ego could not contain the intensity of the aggressive feelings. Her initial
response was to displace the aggression in somatization (hyperventilation attacks led her several times to hospital emergency rooms)
and behaviour outside the analytic hour (involvement in a minor automobile accident after running a yellow light).
 Not long after this J brought the analyst a gift. Instead of accepting it, the analyst encouraged an examination of J's thoughts about
her action. At this point J experienced anger directly toward the analyst within the hour itself. This was followed by a dream and an
important series of memories. In the dream J had lost her front tooth. To this she associated first the earlier narcissistic injury suffered
when the younger colleague had been appointed to the bench, then to her tonsillectomy at the age of 6. Reflecting on the latter, J
speculated about its possible castration meanings. But when she remembered that a younger brother, adored by her mother, had also
had his tonsils removed at the same time, she wondered whether her associations about castration had been too facile. Her musings led
to the recollection of a childhood custom that she and her mother had maintained from the time J was a very small child until her
adolescence; that of a nightly bath given to J by her mother. (With the beginning of her menarche, J refused her mother's ministrations
and the ritual ceased.) In her memories, J described the many conflicted emotions surrounding the bathing since her mother inevitably
at some point, in some fashion, made an exasperated comparison between the genitals of little boys and girls. ('Boys are clean. Girls
are dirty.')
The recaptured painful images of her mother's ambivalent caretaking led J back to her impressions that the analyst had mistreated
her; that is, back to what she had perceived as his assumption that she would automatically pay his raised fee and drive the additional
miles to his new office. As J spoke, she reported genital sensations which brought to her mind the realization that in fact it had always
been her wish that her mother bathe her in order that she might be closer to her mother. She recognized then that as she wished for the
analyst's attention to her, she feared his rejection.
This sequence of associations illustrates J's penchant early in the analysis to view herself as the rejected child, rather than to
address the conflict about viewing herself as a woman. She preferred the security and limitations of a pregenital attachment to the risk
of being seen (and seeing herself) as the unloved, unclean woman. Here, the bedrock of her psychology was demonstrated not as penis
envy, but perceived maternal rejection. She had defensively remembered the negative side of her bathing experiences in order to
maintain the de-eroticized attachment to her mother.
Subsequently J began to come uncharacteristically late to her appointments. She attributed her tardiness to symptoms of an
intestinal disorder, but expressed curiosity about the possibility of a relationship between symptoms (occurring as they did just at this
time) to the analysis. Here, J introduced memories regarding the circumstances around the termination of a second period of
psychotherapy twenty years earlier. J had then experienced resistance to uncovering important aspects of her early life. The psychiatrist
told her she would have to use the couch to overcome her defensiveness. J recollected that as she had left his office following this, she
had felt damp and sexually aroused. When J reported her feelings to the psychiatrist in the next hour, he interpreted them as evidence
of her having made sufficient progress as to warrant, from a Rankian perspective, termination of the psychotherapy shortly thereafter.
As J reported this incident in the analysis she experienced episodes of severe abdominal pain causing her to miss several analytic
hours. Her internist was unable to make a diagnosis. In the middle of this somatic crisis, J reported the account of a younger female
acquaintance who had been propositioned at a party by a physician. J found thoughts of this sexually arousing. At the next hour, J
expressed concern and uncertainty as to whether or not she had perhaps accidently voided upon the analytic couch during the previous
session. The analyst inquired whether J were more comfortable worrying about incontinence than examining her anxiety about sexual
arousal. This brought to J's mind the pleasure of an ancient childhood
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masturbatory practice accomplished by withholding urine and taking pleasure in its passage. As J then reflected upon her experience of
sexual arousal, her perception of dampness and her feelings of acute shame over the fact that for some time she had experienced
occasional instances of minor urinary stress incontinence, her attention was brought to the fact that she repeatedly chose to focus on
her shame over incontinence rather than exploring her sexual feelings.
At this point the analyst again experienced strong countertransference pressure in the form of the temptation to accede to the
patient's self view as a non-sexual older female suffering 'after all' from a frequent problem (intermittent stress incontinence)
associated with women of this age. To have colluded with the patient in the illusion (of the patient's non-sexuality) by not aggressively
seeking its countertransferential meaning to the analyst (his avoidance of confronting the incestuous fantasies regarding the maternal
object) would have been to miss the patient's use of her physical condition as a form of resistance to exploring her own sexual fantasies
in greater depth. It would also have reified her defences in a way that would have made it difficult for the patient to separate the
neurotic from the physiological aspects of her condition and to deal effectively with each, as she was, in fact, subsequently able to do.
The transference interpretations made it possible for J to differentiate the issue of her incontinence from that of sexual excitation.
This led to a broader examination of other areas which had been contaminated by shame. For example, J became aware that she had
displaced shame from her genitals to the products of her mind. She then began to understand her recent inhibition against competition
which she had initially interpreted depressively as a form of mental deterioration or stagnation. This analysis of J's shame marked the
beginning of the second half of the analysis.
In the last half of the analysis, the transference shifted to include first a mixture of dyadic and triadic configurations and, during
the final year of the analysis, a predominance of triadic. Concomitantly, J came increasingly to regard the analysis as an opportunity
for conflict resolution. When J had first 'approached' oedipal level sexual material in the transference, her associations regularly drifted
away to pregenital wishes and memories. But as her interest in understanding the role that conflict played in her life became stimulated
by repeated clarification and interpretation of this pattern, J experienced a further expansion of her analysing instrument. This
combined with her persistent commitment to candour allowed the working through of conflicts to continue in the face of resistances
that assumed new forms during this last half of the analysis.
One such resistance surfaced in the form of J's introduction of plans for termination. The manifest reason for this lay in the issue
of her possible retirement from active practice which had been voiced at the firm. J's anxiety/urgency was at first experienced by the
analyst countertransferentially. 'Perhaps she is right. The analysis is "taking" too long. At her age can she afford to commit an
unlimited amount of time to the analysis? Do I not need to modify the goals of the analysis and be concerned about its duration?' Upon
examination, the analyst's concern about the analysand's endurance revealed conflict regarding his own views vis à vis ageing. As this
yielded to self-analysis, the analysand's sense of pressure was explored for its defensive function against allowing the analytic process
to deepen.
In response to the interpretation of 'the limitations of age' as resistance to the further uncovering, J embarked on a prolonged
working-through process during which her cloacal view of her genitals and mind began to alternate with a more oedipal/genital/playful
self view. The latter manifested itself in a greater mental agility and an enriched sense of humour which J now brought into the
analysis as active substitutes for the earlier giving of a gift. Over all, there was a pervasive sense of amplified genitality and an
attractiveness in which J took pleasure.
As J negotiated these fluctuations (pre-oedipal/cloacal, oedipal/genital) she increasingly recognized the utility of her observing
ego. She began to enjoy the opportunity for the self analysis which it afforded her. For example, she reported a dream in which she
saw the hand of a dark-skinned child. Thinking of her experiences at the beach with her own family, her own
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suntanned hand as a child, J associated to

a second earlier dream in which she sat as a young girl in her bathing suit on a green canvas beach chair by the ocean. High up
on the beach her indifferent father passed, dressed in Edwardian finery. The canvas chair in which she sat had a wet spot on it.
Was it from a wet bathing suit?
The canvas chair reminded her of the green analytic couch. In the face of her conflicted feelings about her sexual attraction to her
father and now transferentially to her analyst, she understood her vulnerability to the regressive pull of her dyadic attachment to her
mother. She understood that this was mobilized by fears that her longings for her father/analyst would be ignored. Further, she
gradually understood that to acknowledge such longings, that is, to see herself as an attractive, desirable woman, was to risk
humiliation and disparagement and separation from her mother/analyst. The ability to analyse the remobilization of these sexual
conflicts in the transference confirm L's confidence in her analysing ego. She speculated about
another dream of an old car which belonged to her and which, it would appear, had no means of entrance. The door handle was
gone. Yet, she found she could reach through the window.
Of this dream, J remarked, 'There is so much that I now realize I can do for myself.'
Three months before termination, a date was agreed upon. J retrieved memories which had not entered the analysis before. They
concerned J's old nursemaid who had cared for her in a loving and accepting way during the first three years of J's life. J then realized
that in her mother's final years, she herself had been able to be very helpful and caring in the same loving way. Furthermore, she
recognized with compassion that her mother's life had been long and difficult.
The frequency of references to oedipal level material accelerated. For example, J reported that at a pre-litigation strategy session
she had become aware of another female lawyer's heightened competitiveness with her. This woman, vexed by the flirtatious attentions
that the males in the group were paying to J, made a series of provocative counter-proposals. Instead of avoiding the hostility and
retreating, J addressed each point of disagreement, negotiated a solution and successfully completed the session. In her self analysis, J
had been aware of her strong impulse to accept as a pyrrhic victory the men's attentions to her and to allow them to confront the issues
raised by her competitor. She was also cognizant of the oedipal transference meanings of the mobilized sexual and competitive
feelings. Musing about the relationship of age to crystallized versus fluid intelligence, she compared her own thinking to that of others.
J spoke with pleasure about her enjoyment of the advantages of the more reflective and circumspect qualities of the crystallized
intelligence which increases with age.

CONCLUSION
In the course of this analysis, the analysand brought a number of issues into the hour, all of which wore the exclusive look of age-
specific reality concerns. Upon closer inquiry they were seen to mask both transference and countertransference issues. Under the
scrutiny of self-analysis the issues were recognized by the analyst as the loci of various countertransference distortions associated with
the analyst's own phase specific issues. It is of note that the analyst's personal countertransference distortions had the misfortune of
having their available counterparts 'out there' in commonly held stereotypic beliefs about the older women. Firstly: there was the
distortion that with age there is an automatic atrophy of genital sexuality leaving only pregenital, erotic transference attachments
available, rather than a repression of genitality due to neurotic conflict. Since J's pregenital conflicts certainly presented powerful
resistances in her analysis, it would have been easy to assume that the causative factor was the patient's age. One could then have
readily misattributed the long working through period of this patient's pregenital conflicts to the inevitability of Balint's assumption: 'In
the face of flagging genitality, infantile sexuality resumes the importance it had early in life …' (Abraham et al., 1980p. 147). This
would have missed the correct understanding of these conflicts as a mutable aspect of J's character structure. The facts of J's case were
that she adopted the issue of age in the service of her defence against the perceived oedipal danger of her genital wishes. When
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one compares what J was able to achieve in her analysis of this defence to that of other analysands, decades younger, one is convinced
that the extended duration of the working through period in this analysis was not age specific. From the experience of the analyst's own
personal analyses and those of colleagues, it is obvious that age bears no relation to the length of the analysis.
Secondly: there was the vulnerability of the analyst to the patient's somatizations. As the patient's physical concerns and
symptoms were in concert with the actuarial liabilities of her age, both the patient's resistance and the analyst's countertransference
response posed potential road-blocks to the forward movement of the analysis. Self analysis was pivotal in identifying the analyst's
temptation; (1) to see the patient non-sexually in order to avoid confronting his own conflicts concerning maternal objects; (2) to
regard the patient as the weakened parent with the associated wish to intervene, rescue and/or supervise the patient's extra-analytic
medical care. The patient's anxious speculations about somatic symptoms, her questions about surgical procedures and diagnostic
hospitalizations to which she subscribed, constituted seductive arguments to her physician/analyst to assume a more supportive and
less uncovering approach. However, throughout the analysis, it was left to the patient to make all decisions about, and provisions for,
her medical care. In this way the analysis was protected so the patient was able to analyse somatizations in terms of the defensive
function they served.
Thirdly: there was the danger that the analyst would be deceived by the analysand's resistances to conflict analysis by accepting
her protestations of its limited value in view of her reduced opportunities for new relationships. Because of J's age, there was the
temptation for the analyst to support such resistances to transference analysis; to provide a real relationship rather than to maintain the
analytic relationship which made possible the analysis of her conflicts.
In sum, the countertransferences noted in this report which were camouflaged as rescue fantasies rendered the analyst liable to the
gamut of temptations cited above. ('To return the gift of life that she [mother] gave him at birth, to become both father and child'
(Freud, 1910p. 172).' These fantasies stemmed from the analyst's core of oedipal level conflicts. In contrast to the oedipal struggles
arising from sexual fantasies about the omnipotent parent that are familiar to us all from our own analyses, we are far less cognizant of
those conflicts arising from fantasies centring about Pearl King's 'weakened parent', and the complications introduced by the reality
that many analysts are dealing with their own weakened or dying parent. We have suggested that conflicts arising from our fantasies
about the older sexual female patient experienced as the incestuous maternal parent have not yet been fully or sufficiently explored and
understood in the literature. It remains an area, a casus belli, without many interlocutors.
A further point of consideration in this report are those countertransferences related to the reality that at mid-life and beyond the
generic tasks with which the analyst himself was working to master touched upon those with which the older analysand was also
reworking or defending against in the analysis. That is, the core oedipal conflicts of both the analyst and patient were recast in similar
stage specific terms. It is suggested that as in most cases, these are issues for which the analyst had not yet completed his own
reworking process.
While the predominance and centrality of countertransference phenomena in the analysis of this older patient at first appeared to
be unique, examination indicated that it was the specific nature rather than the quantity of the countertransferences which gave them
their distinction. Their management nevertheless remained the same, as in every analysis, since alertness to countertransference
phenomena is of course a fundamental aspect of the analyst's work.
Countertransference distortions notwithstanding however, the most enlightening and rewarding aspect of this analysis of an older
patient was its demonstration, in vivo, of the correctness of Freud's observations about the timelessness of the unconscious and the
universality of infantile conflicts regardless of age or sex. To this end both analysts and older analysands will benefit equally from
additional robust exploration of countertransference distortions, some aspects of which were presented in this case.
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SUMMARY
The apparent reluctance among analysts to begin an analysis with a patient beyond his or her fifth decade, a view first articulated
by Freud, is examined as an instance of countertransference resistance. Although there is no greater consensus among analysts than the
continuing necessity of self-analysis irrespective of age, it is an attitude which does not appear to be so readily extended to the older
prospective analysand. This report examines countertransference issues within the context of a seven year classical analysis of an older
female who began an analysis at the end of her sixth decade. The case illustrates the timelessness of psychological conflicts at all
levels and the particular character of the analyst's countertransferences that surfaced listening to the material of this older analysand.

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Article Citation [Who Cited This?]

Wylie, H.W., Jr. and Wylie, M.L. (1987). The Older Analysand: Countertransference Issues in Psychoanalysis. Int. J. Psycho-Anal.,
68:343-352

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