Psychodynamic Perspectives on Aging and Illness / Edition 1

by Tamara McClintock Greenberg

Overview

More than ever, the aging process is recognized as carrying a special set of emotional challenges–especially when acute or chronic medical conditions are involved. In this light, Psychodynamic Perspectives on Aging and Illness presents a fresh, contemporary application of psychodynamic theory, addressing the complex issues surrounding declining health. Informed by the spectrum of psychodynamic thought from self, relational, and classical theories, this forward looking volume offers more modern interpretations of theory, and techniques for working with a growing, complicated, but surprisingly resilient population. It illuminates how to enhance the therapeutic relationship in key areas such as addressing body- and self-image issues, approach sensitive topics, and understand the disconnect that can occur between medical patients and the often impersonal, technology-driven health care system. At the same time, the author cogently argues for pluralism in a therapeutic approach that is frequently threatened by forces both within and outside the field. Among the topics covered:

• Medical illness as trauma.

• Idealization and the culture of medicine.

• Normative and pathological narcissism in the ill and/or aging patient.

• Noncompliant and self-destructive behaviors.

• Transference and countertransference issues.

• Psychotherapy with cognitively impaired adults.

• Grief, loss, and hope.

Expanding on what we know and candid about what we don’t, Psychodynamic Perspectives on Aging and Illness offers mental health researchers and practitioners an insightful framework for improving the lives of older patients.

Product Details

ISBN-13:	9781441969729
Publisher:	Springer New York
Publication date:	06/29/2010
Edition description:	2009
Pages:	150
Product dimensions:	6.10(w) x 9.25(h) x 0.24(d)

About the Author

Tamara McClink Greenberg, PsyD, MS is an Associate Clinical Professor in the Department of Psychiatry at the University of California, San Francisco, where she supervises psychiatry residents. She has worked with medical and aging patients for the last twenty years in hospitals, long-term care facilities and in her outpatient practice. Dr. Greenberg is the author of four books and a number of contributed chapters, which have encompassed both academic and popular press writing. She has written for Psychology Today online, Psych Central and The Huffington Post. She has been a speaker to audiences and the media on topics such as aging, illness, the stresses associated with caretaking, grief, the trauma of illness, coping with aging, women’s issues and the application of psychodynamic ideas for people struggling with health problems and those that try to help them. A major focus of her writing has been on how loved ones and patients can deal with doctors and the medical system in a more empowered way, while being mindful of the difficult and unique stressors physicians and medical staff face in this ever-complicated medical landscape. Dr. Greenberg lives with her husband and two pugs in San Francisco.

Table of Contents

When the Body Intrudes: Psychotherapy with Older and Medically Ill Adults.- Psychoanalytic theory and the body.- Applying psychodynamic concepts to aging and medically ill patients.- Aging and the medically ill: An increasing population.-Technology, Idealization, and Unconscious Dynamics in the Culture of Medicine.- The hypomanic culture of medicine.- Patient expectations in medicine.- Technology and idealization.- Looking for love (and a cure): Medical relationships.-The Trauma of Medical Illness.- The mental health clinician and medical patients.- Medical illness as adult onset trauma.- Past trauma in the context of aging and illness.-Narcissistic Aspects of Aging and Illness.- The concept of narcissism within psychodynamic theory.- The "mid-life crisis".-Transference and Countertransference in Aging and Illness.- Transference and implications for older and medically ill patients.- Countertransference feelings in working with medical patients.-Self-destructive Behaviors, Masochistic Dynamics, and Illness.- Psychodynamic ideas on masochism.- Masochism and the body.- Cognitive Changes and Implications for the Therapeutic Encounter.- Cognitive impairment in the elderly.- Normal physical changes related to aging.- Psychotherapy with cognitively impaired adults.-What We Know and What We Don’t: The Influence of Psychological Factors on Medical Illness.- Heart disease.- Osteoporosis.- Cancer.- Child Abuse.- The meaning of the research on psychological factors and medical risk.-Hope and Grief: The Introduction of an Emotional Language.- Alexithymia: Adaptive aspects of psychic detachment.- Alexithymia and hysteria.- Trauma, the sense of self and therapeutic action.- (Epilogue) Resilience in the elderly and medically ill.

Editorial Reviews

From the reviews:

"In Psychodynamic Perspectives on Aging and Illness, Tamara McClink Greenberg provides the medical and psychological community with an exceptionally incisive and truly groundbreaking tour de force. The book picks up where the biopsychosocial model of George L. Engel, M.D. left off in the middle of the 20^th century and expands that view with a new depth. As such, this work remedies what many have considered to be the limitations of that theory. Dr. Greenberg has illuminated the factors implicated in health and illness with a clear and concise perspective culled from the best of contemporary psychoanalytic psychology in a manner not previously accomplished. This work will be valued by all who come into contact with illness, suffering, pain, aging and death. With clearly elucidated concepts, vivid clinical examples and the benefit of her own personal narrative, the book is both compelling and educative. For those who work in medical settings, especially in health psychology and consultation liaison psychiatry, this text presents the definitive study of the nature of the experience of caring for sick people in our society. It will be required reading for a long time to come."
-Marilyn S. Jacobs, Ph.D., ABPP, Assistant Clinical Professor of Psychiatry, David Geffen School of Medicine at UCLA Medical Center, Los Angeles

"Dr. Tamra McClink Greenberg, in her new book, Psychodynamic Perpectives on Aging and Illness … presents keen insights for understanding your parents feelings and behaviors. The book is geared towards professionals who work with the ‘aging population,’ … . After reading her book I thought you would find a session with Dr. Greenberg … interesting. … I will be sure to recommend your book to all the staff … ." (The Huffington Post, October, 2009)

“Taking a more modern approach to the application of psychodynamic theories to aging and illness, this book emphasizes thetherapeutic relationship and current relational functioning. … both experienced clinicians and patients may find this book helpful. … graduate students in clinical/counseling psychology and social work also would find it helpful. … This is a great book for clinicians who want to use psychodynamic theory with the elderly.” (Gary B. Kaniuk, Doody’s Review Service, June, 2010)

"This is a straightforward read, offered to present-day medical practi- tioners and mental health professionals to help with the art of treating older people. It examines this burgeoning population with a wide lens, taking in every feature, especially its impact on all the professionals pro- viding therapy: psychiatrists, psychologists, internists, and neurologists, as well as nurses, caseworkers, and personal caregivers. The author ad- dresses the technical and conceptual challenges, the major dynamics in these treatments, and the role of medical conditions...Psychodynamic Perspectives on Aging and Illness will provide the essential optimism, confidence, and technical proficiency needed for clinicians coping with referrals from the aging population." (Anna Burton, MD., The Psychoanalytic Quarterly, 2011)

"The purpose of Psychodynamic Perspectives on Aging and Illness is to highlight the need to better understand and apply psychodynamic theory and associated psychodynamic approaches to the treatment and care of older adults. The book argues that understanding aging-related reactions and sub- sequent adaptation issues needs a reconceptualization, shifting from a more “traditional” intervention approach to an approach grounded in psychoanalytic thought. The target audience for this book is practitioners caring for an aging population, geriatric clinicians, and anyone wishing to better understand personal reactions to aging. However, it is not necessary for the reader to have a background in psychoanalytic training to generally understand the ideas expressedin the chapters. Furthermore, the book is a useful guide for most individuals, both professionals and laypersons, interested in the interplay of the mind-body connection into later life.

The book has a good overall text structure, proceeding from psychodynamic foundation concepts to more advanced application issues. Overall, the book is very well written and logical in its progression of thought from chapter to chapter. Although each chapter is related to the preceding and proceeding chapters, the book is useful because each chapter can easily be read independently for reference purposes. In terms of writing style and ease of reading, the author achieves a good combination of technical and nontechnical writing usage for a wide audience interested in aging issues. The references cited at the end of each chapter reflect a range of both historical background and current thought in the field. The book is very timely in terms of understanding better approaches to addressing the adjustment needs of a growing aging population. Even though the text is very well written, it might benefit from the incorporation of more illustrative figures, tables, and appendix materials to further reinforce the text information.

The overall strength of Psychodynamic Perspectives on Aging and Illness is that it comes at a time when the quality of life of older adults is increasingly a concern, and it offers a compelling argument for an approach to reexamine this societal issue. In conclusion, the book is highly relevant and important to many areas of practice (and research). Only through this important examination of how we can better understand the “internal world” of aging can we hope to effectively create more positive quality-of-life outcomes for a growing segment of our population." (Lisa Hollis-Sawyer, Ph.D., Gerontology Program Coordinator Department of Psychology Northeastern Illinois University Chicago, IL)

"Greenberg does a superb job of covering alarge territory, while conveying empathy for her patients, and an understanding of the tremendous energy required for living with a compromised body. She delivers on her promise to bring together the two lenses of the medical and analytic fields in later life...One understandable result of this breadth is that in places, it leaves one wishing for more depth, and those of us working with seniors can continue to investigate, within our professional communities, the considerations that Greenburg puts forth. Her book may not assume readers (aside from those already "in the know") of the enjoyable aspects of elder psychotherapy, but perhaps that's to be expected. Treating aging and ailing people - who may not live long enough to experience the full benefit of long-term therapy and who stir up all kinds of existential anxities in their therapists - might be a hard sell, but it can be as absorbing and life-changing as any other kind of work." (Willow Banks, M.A., fort da (2014), 20 (2), 107-113)

From the Publisher

Reviewer: Gary B Kaniuk, PsyD (Cermak Health Services)
Description: Taking a more modern approach to the application of psychodynamic theories to aging and illness, this book emphasizes the therapeutic relationship and current relational functioning.
Purpose: According to the author, "this book attempts to bridge the best of contemporary psychodynamic theory with what I have found to be true for the patients I have treated over the years who have acute and chronic illnesses and who have wrestled with the bodily declines associated with aging. Psychoanalytic and psychodynamic theorists have been hesitant to apply their concepts to people who are aging and/or medically ill."
Audience: The book "is geared toward therapists who are interested in psychodynamic theory, but may have encountered difficulties in graduate school in learning a more nuanced psychodynamic approach," according to the author. She also suggests that both experienced clinicians and patients may find this book helpful. I would add that graduate students in clinical/counseling psychology and social work also would find it helpful.
Features: The book begins with a discussion of the effects of aging and illness, and the emotional changes that occur in response. It also shows how psychological factors affect various illnesses such as heart disease, osteoporosis, and cancer. The author is honest about the limitations of traditional psychodynamic approaches in helping the elderly, which prompted her efforts to adapt the theory to make it more helpful to patients, without forsaking the basic foundation. She believes that using a more modern psychodynamic approach has greater explanatory power and will enhance the treatment process. She talks about the "hypomanic culture of medicine," a fast-paced, pressured culture where doctors have limited time to see each patient. The book also addresses how medical illness can be seen as adult-onset trauma and creates a narcissistic injury. Transference and countertransference are still very important concepts in this adaptation of psychodynamic theory. The book includes important information on self-destructive behaviors and cognitive changes that occur as a result of aging and/or illness. It ends with an understanding of therapeutic action, especially dealing with alexithymia or psychic detachment. The many case vignettes are extremely helpful.
Assessment: This is a great book for clinicians who want to use psychodynamic theory with the elderly. The author has formulated a more modern approach while keeping the basic concepts intact. The case vignettes are excellent. This book will give clinicians useful tools from a theoretical foundation that has great explanatory power.

Doody's Review Service