Hope and Grief: The Introduction of an Emotional Language

Abstract

Throughout this book, I have attempted to describe various aspects of emotional experience related to the process of aging and illness. Although the patients whose case histories I have discussed portray varied levels of psychological functioning, different personalities, character structures and defenses, there is one major theme that is common to all of them: the difficulty in accessing an emotional language due to the concrete demands of bodily illness or concrete focus on the body.

While I have described how ageism, and the fear of illness or death on the part of therapists may explain the hesitation of traditional psychoanalysts in addressing the needs of medically ill and older patients, the challenges that these patients bring to the therapeutic setting in talking about their internal and mental experiences creates unique difficulties for working with this population. In this chapter, we will revisit the concept of alexithymia; I will suggest that this idea can be expanded and applied to our work as clinicians, but without the pejorative connotations that are often associated with the dilemma of lacking the right words to describe feelings, or the assumption that illness is psychosomatic. I have argued that traditional approaches are not useful for many medical and aging patients; I will also describe how we might understand aspects of the therapeutic encounter with this population. Finally, I will contextualize the hope and grief our patients face, with a focus on the resilience of the elderly and medical patients, as these individuals often want to learn ways they can expand their emotional landscape towards a more nuanced and developed internal dialogue. The quest for meaning and insight in these patients implores us to continue to find ways to connect with and help this growing population.