Foreward; Preface; Contents; About the Author; Chapter 1: When the Body Intrudes: Psychotherapy with Older and Medically Ill Adults; Why Psychodynamic Approaches? Evidence on Efficacy; Traditional Ideas About Aging and Illness; Applying Psychodynamic Concepts to Aging and Medically Ill Patients; The Boom in Aging and Medical Illness; Conclusion; References; Chapter 2: 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 Suggested Techniques: How to Talk with Patients about Manic Defenses; Conclusion; References; Chapter 3: The Trauma of Medical Illness; Do We Have to Talk about It? The Mental Health Clinician and Medical Patients; Fear and Confusion in Illness; Shame and the Trauma of Illness; Denial and the Need to Escape; Past Trauma in the Context of Aging and Illness; Suggested Techniques: Creating Safety in the Context of Avoidance; Conclusion; References; Chapter 4: Narcissistic Aspects of Aging and Illness

Everyone's a Little Narcissistic: When a Normal Defense Becomes Excessive A Body (and Mind) without a Home: Late Life Consequences of Early Loss; Letting Go of a Perfect World: The Silhouette of Mourning in Narcissistic Patients; The "Midlife Crisis"; Suggested Techniques: Providing a Place to Think; Conclusion; References; Chapter 5: Gray Areas: When Illness May Be Particularly Impacted by Psychological Variables; How Do We Define "Psychosomatic" and Does It Matter?; How Stress Lands in the Body: The HPA-Axis; Back to Hysteria? No and Yes

Suggested Techniques: Clarifying Affective Confusion Conclusion; References; Chapter 6: Transference and Countertransference Considerations; Transference and Implications for Older and Medically Ill Patients; Countertransference Feelings as a Reaction to Vulnerability; Countertransference: When Older Is Easier (for Therapists); Countertransference: Social Contextual Issues; Suggested Techniques: Modern-Day Transference Interventions; Conclusion; References; Chapter 7: Self-Destructive Behaviors and Illness; Psychodynamic Ideas on Masochism

Achieving Control No Matter What: The Demand to Be Fixed Unhealthy Behaviors and the Desire to Ignore the Truth; How Anger Leads to Attempts at Mastery; Failed Attempts at Denial and Homeostasis; Suggested Techniques: The Careful Balance of Addressing Aggression; Conclusion; References; Chapter 8: Cognitive Changes and Implications for the Therapeutic Encounter; Cognitive Impairment in the Elderly; Normal Physical Changes Related to Aging; How to Detect Delirium; Psychotherapy with Cognitively Impaired Adults; Suggested Techniques: Discussing Impairments; Conclusion; References