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When the Body Intrudes: Psychotherapy with Older and Medically Ill Adults

  • Tamara McClintock Greenberg
Chapter

Abstract

In this extraordinary age of advances in medical technology, people live longer than any other time in history. As mental health clinicians, we are now treating a greater number of older and medically ill patients than ever before. These populations: aging adults, medically ill adults, and those who are both older and medically ill, are the subjects of this book. Aging and illness are not always mutually exclusive. Although aging does not necessarily imply the presence of illness, it is an independent risk factor in the development of disease. Additionally, bodily changes that accompany aging are inevitable, and as we age, we are all confronted with the limits of physical abilities. However, naturally occurring physiological effects of aging, emotional reactions to the aging process, and the impact of medical illness vary widely from person to person. Therefore, some sections of this book will address aspects of aging that are distinct from medical illness.

As psychodynamic clinicians, we are not only in the position to reduce the psychological distress that accompanies aging or illness, but we have the unique ability to make sense of the complicated and sometimes confusing emotional states that can result in response to bodily changes and limitations. Consider the following example:

Betty is a 79-year-old female who has no cognitive difficulties beyond what would be expected of someone her age. She is in good health, though her vision has declined slightly due to mild macular degeneration. She has no history of mental health problems. However, around the same time that her vision changed, she began having anxiety and depressive symptoms, and her primary care physician observed increasingly guarded behavior. Eventually, Betty began to suspect, and then complain that others were entering her apartment while she was gone, and stealing her furniture. She spent increasing amounts of time “checking” her furniture to make sure it was not missing. As it was evident that no one was really breaking into her apartment, she developed stories to explain how her furniture had been moved or stolen and then moved back to its original position.

Keywords

Medical Patient Mental Health Treatment Medical Illness Mental Health Clinician Psychoanalytic Theory 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of CaliforniaSan FranciscoUSA

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