Psychoanalytic reflections on limitation: Aging, dying, generativity, and renewal.

Abstract

In this written version of a talk given to a Division 39 audience, the author reflects on issues of limitation, including mortality. She addresses the evident reluctance of many analysts to engage at a personal level, both clinically and theoretically, with aging, loss of function, and dying and invites a conversation about how elderly therapists may prepare for the impact on their patients of their eventual decline and death. She attributes part of the widespread avoidance of such issues to implicit Western-especially American-cultural ideologies, which are replete with Lockean-era assumptions that resources are boundless, that problems are all fixable, and that individual entitlements are more concerning than communal needs and obligations. She contrasts such attitudes with dominant psychoanalytic sensibilities and clinical knowledge, drawing some inferences for the profession. She considers the positive aspects of limitation, including some ways it opens up possibilities for creativity and generativity. Finally, she takes up specifically the aging of members of Division 39 and other psychoanalytic groups, the accomplishments of the current generation of analysts, and the challenges to be faced by psychoanalytic professionals in the next generation.

Sameness and Solidarity in the Supervisory Environment

“…These challenges might urge some therapists to consider partial or full retirement, whereas other therapists feel they can compensate for these challenges with their rich clinical experience and theoretical knowledge and dismiss the notion of retirement. Despite their different choices, therapists in both groups gradually develop an acknowledgment of the transience and delicacy of their professional lives (Williams, 1997; McWilliams, 2017; Akhtar, 2018).…”

Mental health professionals preparing for cognitive decline and death: Denial and action.

“…When clinicians do not plan for their death and their clients learn about this suddenly, it complicates, undermines, and typically devastates the client (Becher et al, 2012;Garcia-Lawson et al, 2000;McGee, 2003;Pope & Vasquez, 2016). When a client arrives at their therapists office to suddenly discover that their mental health professional is dead, it is-understandably-traumatizing (Cohen, 1983;McWilliams, 2018;Pinsky, 2018). In fact, there is empirical as well as anecdotal support for the notion that patients who experienced their therapist's unexpected demise experienced significantly more intense grief reactions with regard to feelings of anger, despair, depersonalization, and somatization (Garcia-Lawson et al, 2000).…”