Elderly patients

If young suicides awaken the therapist's fantasies about salvation, then older patients are more likely to cause irritation, often they are treated with medicines and hospitalized without psychotherapy. Many come to the unjustified conclusion that psychotherapy can do little to help older people in general and suicides in particular.

However, many older people, despite the seriousness of the problems, showed this or that ability to adapt. And, probably, life-proofing adaptability is a more important indicator for predicting the results of psychotherapy than age.

Case 4. A professor of sociology, 65 years old, began to think about suicide after a stroke that caused almost complete left-sided paralysis. He experienced depression, rage and could not accept the decline in physical and mental abilities. He declared to me: “When you left the office, I followed you like a hawk. You are quite able to use your left hand and foot, and I am filled with anger and envy. ” He became unbearably irritable to his wife and foster children, although he had previously been on good terms with them. He was fully aware that he was angry at their ability to move as they please, while he had to endure the limitations of illness.

Past life has made him particularly vulnerable to this situation. He grew up with a strong need for self-sufficiency and control, frustrated by the indifference of the mother. In many ways, his self-esteem, he raised the academic activities. He was considered the best teacher of the department, often received awards for success in work, won several professional awards. His wife confirmed that most of the students considered him the best teacher they met on their way.

For the past five years, he often had one dream. He gives a lecture to the audience, then flaps his arms like wings, rises to the ceiling, makes a circle above the hall, flies out the window and hovers above tall trees. And he has a fear of heights. After the story about the dream, it becomes clear that he really “flies” in teaching, winning the respect of colleagues and the deep respect for students.

His wife also admired and respected him. But his own self-esteem was so connected with the universal admiration for his achievements, knowledge and ability to control various difficult situations, that he simply could not imagine how his wife could continue to love him in the present, partially helpless state. As a result, he increasingly nagged at her, gradually pushing away from him.

At one of the sessions, he gave several examples of how he managed to resolve friction between the staff of the hospital where he was treated. I approved these actions. He immediately noticed that before his abilities were much higher. He devalued any current achievement, comparing with past successes. This setting was central to the process of psychotherapy, and as soon as he managed to change it, his mood improved.

An even greater role was played by his passive attitude to the results of rehabilitative treatment and life in general, which bordered on doom. He wanted more freedom of movement around the hospital, but he didn’t ask a doctor about it. He passively took care of himself, waiting for his wife to come, so that she would fasten her chemise. Before the stroke, passivity was not at all peculiar to him. When I noted this fact, at first he was very indignant. The word "passivity" annoyed him and simultaneously challenged him. But from that moment on, he began to serve himself independently, surprisingly quickly learning to walk with the help of special “walkers”. All subsequent sessions he began with a message about his achievements and how I was mistaken, considering him to be passive. One of the following tasks was to revive the ability to maintain satisfactory relations with his wife and children, which he successfully coped with over time.