Psychodynamics and aging.

Freud felt that by age 50 the mental processes had lost so much elasticity as to make psychological treatment inadvisable. Subsequent workers have been less pessimistic about the potential for conflict resolution in old age. This paper presents three case vignettes to explore psychodynamic aspects of the aging process. Issues discussed include inevitable losses, grief reactions, difficulties with restitution, structural alterations, redistribution of libido and the use of regression rather than repression as a mechanism of defense. Patients such as these are often diagnosed as depressed or demented and treated with psychotropic drugs. Interpersonal psychotherapeutic approaches can be much more effective.