Preface	5
	Contents	9
	Chapter 1 When the Body Intrudes: Psychotherapy with Older and Medically Ill Adults	11
	Psychoanalytic Theory and the Body	13
	Applying Psychodynamic Concepts to Aging and Medically Ill Patients	16
	Aging and the Medically Ill: An Increasing Population	24
	Conclusion	26
	References	27
	Chapter 2 Technology, Idealization, and Unconscious Dynamics in the Culture of Medicine	29
	The Hypomanic Culture of Medicine	31
	Patient Expectations in Medicine	34
	Technology and Idealization	36
	Looking for Love (and a Cure): Medical Relationships	40
	Conclusion	43
	References	44
	Chapter 3 The Trauma of Medical Illness	46
	The Mental Health Clinician and Medical Patients	47
	Medical Illness as Adult-Onset Trauma	54
	Past Trauma in the Context of Aging and Illness	61
	Conclusion	64
	References	65
	Chapter 4 Narcissistic Aspects of Aging and Illness	67
	The Concept of NarcissismWithin Psychodynamic Theory	68
	The “Midlife Crisis”	76
	Conclusion	80
	References	81
	Chapter 5 Transference and Countertransference in Aging and Illness	83
	Transference and Implications for Older and Medically Ill Patients	84
	Countertransference Feelings inWorking with Medical Patients	94
	Conclusion	100
	References	100
	Chapter 6 Self-Destructive Behaviors, Masochistic Dynamics, and Illness	102
	Psychodynamic Ideas on Masochism	103
	Masochism and the Body	105
	Conclusion	112
	References	113
	Chapter 7 Cognitive Changes and Implications for the Therapeutic Encounter	114
	Cognitive Impairment in the Elderly	115
	Normal Physical Changes Related to Aging	116
	Psychotherapy with Cognitively Impaired Adults	120
	Conclusion	124
	References	124
	Chapter 8 WhatWe Know and WhatWe Don’t: The Influence of Psychological Factors on Medical Illness	127
	Heart Disease	129
	Osteoporosis	132
	Cancer	132
	Child Abuse	133
	The Meaning of the Research on Psychological Factors and Medical Risk	134
	Conclusion	136
	References	137
	Chapter 9 Hope and Grief: The Introduction of an Emotional Language	140
	Alexithymia: Adaptive Aspects of Psychic Detachment	140
	Alexithymia and Hysteria	143
	Trauma, the Sense of Self, and Therapeutic Action	145
	Hope and Grief: Advanced Understandings of Therapeutic Action	147
	Epilogue) Resilience in the Elderly and Medically Ill	149
	References	150
	Index	152