The Psychoimmune System in Later Life

The Problem of the Late-Onset Disorders
  • David Gutmann
Part of the The Springer Series in Adult Development and Aging book series (SSAD)


Since 1978 the faculty, staff, and students of the Older Adult Program at Northwestern Medical School have been studying the etiology, symptoms, and typical course of late-onset psychiatric disorders in middle-aged, young-old, and old-old men and women. For the author, these investigations have led to a still evolving but clinically useful conception: namely, that the various functions of the psyche constitute a de facto immune system, dedicated to preserving the consistency and continuity of the Self. When the immune system is in place, the individual experiences what Erikson (1952) has called a “self-sameness,” and self-recognition in the face of flux and change; when the system fails, the result is self-fragmentation, as well as psychoses based on hectic attempts—“fevers of the soul”—to restore the lost continuity. In later life, immune systems—whether psychic or physical—tend to degrade. The late-onset disorders do not, as commonly assumed, result from the piling-up of nonspecific Stressors and insults in later life; they result from specific, meaning-laden, and potentially reversible attacks on the psychic immune system itself.


Virtual Reality Transitional Object Transitional Space Good Presence Reversible Attack 
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  1. Erikson, E. (1952). Childhood and society. New York: Norton.Google Scholar
  2. Giovacchini, P. (1993). Borderline patients: The psychosomatic focus and the therapeutic process. Northvale, NJ: Aronson.Google Scholar
  3. Gutmann, D. (1994). Reclaimed powers: Men and women in later life. Evanston, IL: Northwestern University Press.Google Scholar
  4. Hammond, J. (1991). A case study of the relocated: A detailed examination of residents and their family caretakers during a radical change. Unpublished doctoral dissertation, Northwestern University, Evanston, IL.Google Scholar
  5. Pollock, G. (1961). Mourning and adaptation. International Journal of Psychoanalysis, 42, 341–361.PubMedGoogle Scholar
  6. Schindler, B. (1985). Stress, affective disorders, and immune function. Medical Clinics of North America, 69(3), 170–197.Google Scholar
  7. Schleifer, S., Keller, S., Siris, S., Davis, K., & Stein, M. (1985). Depression and immunity. Archives of General Psychiatry, 42, 243–252.CrossRefGoogle Scholar
  8. Staines, N., Brostoff, J., & James, K. (1993). Introducing immunology. London: Mosby.Google Scholar
  9. Winnicott, D. (1953). Transitional objects and transitional phenomena. In D. Winnicott, Playing and reality (pp. 1–26). London: Tavistock.Google Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • David Gutmann
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesNorthwestern University Medical SchoolChicagoUSA

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