Not too late: Fortnightly short term dynamic therapy with older people

Abstract

I describe a short-term dynamic therapy of 12–14 fortnightly sessions developed whilst working in a specialist mental health service for older people. Vignettes are given of this therapy with two women suffering from long histories of depression who experienced considerable benefit. They both showed an impressive capacity to reflect on and hold the therapy in mind during the fortnightly intervals and the longer breaks. To their surprise and relief, they did not become depressed during the period of therapy. They were especially pleased to discover an unexpected resilience. Less intensive frequency of sessions with fortnightly intervals offers the advantage of not encouraging a regression in the transference and, whilst recognising the importance of difficulties in early life, can galvanise adult capacities and resources developed over a long life. Particular influences in this work are discussed in the use of play from Winnicott, as described by Smith, and the importance of reaching hopeful and positive aspects of the personality described by Music.