The Race Against Time: Psychotherapy and Psychoanalysis in the Second Half of Life

336 Pages·1985·10.28 MB·English

by  Robert A. Nemiroff M.D.

The Race
Against Time
PSYCHOTHERAPY AND
PSYCHOANALYSIS IN THE
SECOND HALF OF LIFE
CRITICAL ISSUES IN PSYCHIATRY
An Educational Series for Residents and Clinicians
Series Editor: Sherwyn M. Woods, M.D., Ph.D.
University of Southern California School of Medicine
Los Angeles, California
Recent volumes in the series:
LAW IN THE PRACTICE OF PSYCHIATRY
Seymour L. Halleck, M.D.
NEUROPSYCHIATRIC FEATURES OF MEDICAL DISORDERS
James W. Jefferson, M.D., and John R. Marshall, M.D.
ADULT DEVELOPMENT: A New Dimension in Psychodynamic Theory
and Practice
Calvin A. Colarusso, M.D., and Robert A. Nemiroff, M.D.
SCHIZOPHRENIA
John S. Strauss, M.D., and William T. Carpenter, Jr., M.D.
EXTRAORDINARY DISORDERS OF HUMAN BEHAVIOR
Edited by Claude T. H. Friedmann, M.D., and Robert A. Faguet, M.D.
MARITAL THERAPY: A Combined Psychodynamic-Behavioral Approach
R. Taylor Segraves, M.D., Ph.D.
TREATMENT INTERVENTIONS IN HUMAN SEXUALITY
Edited by Carol C. Nadelson, M.D., and David B. Marcotte, M.D.
CLINICAL PERSPECTIVES ON THE SUPERVISION OF
PSYCHOANALYSIS AND PSYCHOTHERAPY
Edited by Leopold Caligor, Ph.D., Philip M. Bromberg, Ph.D.,
and James D. Meltzer, Ph.D.
MOOD DISORDERS: Toward a New Psychobiology
Peter C. Whybrow, M.D., Hagop S. Akiskal, M.D., and
William T. McKinney, Jr., M.D.
EMERGENCY PSYCHIATRY: Concepts, Methods, and Practices
Edited by Ellen L. Bassuk, M.D., and Ann W. Birk, Ph.D.
DRUG AND ALCOHOL ABUSE: A Clinical Guide to Diagnosis
and Treatment, Second Edition
Marc A. Schuckit, M.D.
THE RACE AGAINST TIME: Psychotherapy and Psychoanalysis
in the Second Half of Life
Robert A. Nemiroff, M.D., and Calvin A. Colarusso, M.D.
A Continuation Order Plan is available for this series. A continuation order will bring
delivery of each new volume immediately upon publication. Volumes are billed only
upon actual shipment. For further information please contact the publisher.
The Race
Against Time
PSYCHOTHERAPY AND
PSYCHOANALYSIS IN THE
SECOND HALF OF LIFE
A. M.D.
ROBERT NEMIROFF,
AND
A. M.D.
CALVIN COLARUSSO,
University of California-San Diego
School of Medicine
La Jolla, California
SPRINGER SCIENCE+BUSINESS MEDIA, LLC
Library of Congress Cataloging in Publication Data
Main entry under title:
The Race against time.
(Critical issues in psychiatry)
Includes bibliographical references and index.
1. Aged—Mental health services. 2. Psychotherapy. 3. Psychoanalysis. I. Nemiroff,
Robert A. II. Colarusso, Calvin A. III. Series. [DNLM: 1. Psychoanalysis—in middle age. 2.
Psychoanalysis—in old age. 3. Psychotherapy—in middle age. 4. Psychotherapy—in old
age. WM 420 R118]
RC451.4.M54R33 1984 618.97'68914 84-17683
ISBN 978-1-4899-3483-3
ISBN 978-1-4899-3483-3 ISBN 978-1-4899-3481-9 (eBook)
DOI 10.1007/978-1-4899-3481-9
© 1985 Springer Science+Business Media New York
Originally published by Plenum Press, New York in 1985
Softcover reprint of the hardcover 1st edition 1985
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Treasuring as we do the inspiration that their lives
provided for our own, we dedicate this book to Riva
Nemiroff, to the memory of George Nemiroff, and to
Sarah and Anthony Colarusso-our parents.
Robert A. Nemiroff, M.D. Calvin A. Colarusso, M.D.
To everything there is a season, and a time to every purpose
under heaven:
A time to be born, and a time to die;
A time to plant, and a time to pluck up that which is planted;
A time to kill, and a time to heal;
A time to break down, and a time to build up;
A time to weep, and a time to dance;
A time to cast away stones, and a time to gather stones
together;
A time to embrace, and a time to lose;
A time to keep, and a time to cast away;
A time to rend, and a time to sew;
A time to keep silence, and a time to speak;
A time to love, and a time to hate;
A time for war, and a time for peace.
Ecclesiastes (Koheleth) 3: 1-8
Contributors
CLAIRE CATH, Department of Child Psychiatry, Tufts-New England Med
ical Center, Medford, Massachusetts
STANLEY H. CATH, Department of Psychiatry, Tufts University School of
Medicine, Medford, Massachusetts
GENE D. COHEN, Department of Psychiatry, Georgetown University
School of Medicine, Washington, D.C., and Program on Aging, Na
tional Institute of Mental Health, Bethesda, Maryland
JILL E. CRUSEY, Senior Medical Centers, San Diego, California
MARTIN GROT}AHN, Department of Psychiatry, University of Southern
California, Los Angeles, California, and Southern California Psy
choanalytic Society and Institute, Los Angeles, California
JOHN M. HASSLER, Department of Psychiatry, University of California at
San Diego, La Jolla, California, and San Diego Psychoanalytic Insti
tute, San Diego, California
H. P. HILDEBRAND, Department of Psychology, BruneI University, Lon
don, England, and Tavistock Clinic, London, England
RALPH J. KAHANA, Department of Psychiatry, Harvard Medical School,
Cambridge, Massachusetts, and Beth Israel Hospital, Boston, Mas
sachusetts
GARY A. LEVINSON, Department of Psychiatry, University of California
at San Diego, La Jolla, California, and San Diego Psychoanalytic In
stitute, San Diego, California
ELI MILLER, Department of Psychiatry, University of California at San
ix
x CONfRlBUTORS
Diego, La Jolla, California, and San Diego Psychoanalytic Institute,
San Diego, California
MALKAH T. NOTMAN, Department of Psychiatry, Tufts University School
of Medicine, Medford, Massachusetts
Foreword
This is the second book in the pioneering investigation of adult develop
ment by Robert A. Nemiroff and Calvin A. Colarusso. The first, Adult
Development: A New Dimension in Psychodynamic Theory and Practice, ar
rived to critical acclaim in 1981. It presented a psychodynamic theory of
development during the second half of life and a model of normal adult
functioning. This book is the logical sequel, expanding and elaborating
the original formulations and applying them to the clinical practice of
psychotherapy and psychoanalysis. Nemiroff and Colarusso demonstrate
that these are appropriate techniques for patients in the second half of
life, regardless of age. They lay to rest many stereotypes and myths that
have long interfered with the dynamic treatment of older patients, and
they propose exciting new conceptualizations such as that of adult develop
mental arrests. The genetic approach reaches beyond childhood and
adolescence and takes on important new meaning by incorporating an
adult developmental past that influences both psychopathology and
transference.
The relationship between theory and therapy is richly demonstrated
in the clinical presentations, including ten detailed case histories of pa
tients between the ages of 40 and BO. These and other clinical discussions
provide ample evidence that a psychodynamic approach that is based on
a sound adult developmental psychology can be extraordinarily effective.
They also demonstrate both the similarities and differences in working
with older versus younger patients.
This work is a major contribution in a long-neglected dimension of
clinical psychiatry.
SHERWYN M. WOODS
xi