I will be 80, or perhaps even 81, in my sixth decade as an aspiring psychologist/analyst, by the time this book is published. I was born and have lived in the New York-New Jersey metropolitan area all my life, and my formal education has been there as well. I am a widow of 22 years, after 30 years of marriage, mother of five, and grandmother of eleven. A first-generation American, I stem from a middle-class German- and Austrian-Jewish background, and currently practice as a psychoanalyst/psychotherapist in suburban New Jersey.

That is who I am today. But the odyssey that brought me to this day was fraught, in younger years, with agonizing embarrassment and self-doubt. My father was an assimilationist, a Jewish-born man who Christianized his children to save them from the rife anti-Semitism that suffused society in those years and, he feared, would diminish his children's life chances in crucial ways. And so we were enjoined, without any explanation, to conceal our Jewish origins and to attend a Presbyterian Sunday School.

Neither parent ever entered the doors of that little suburban church, nor attempted to conceal their origins. In fact, Father would regularly ask, at our weekly Sunday roast beef dinner, what we had learned in Sunday School that day. "Nonsense, mystical superstitious nonsense," was his characteristic response to our replies which, naturally, were couched in the traditional Calvinistic belief system. While he believed he was thinking rationally and acting in the best interests of his children, he was actually planting a corrosive sense of shame in me, as I understood only that who we truly were was something one should hide. The occasional anti-Semitic remarks made by folks in that almost wholly Wasp suburb, who thought I was as Presbyterian as they, did little to relieve me of that shame. I have that early pain to thank for my awareness of the importance for patients when family secrets generate shame. I am thankful, too, that during undergraduate years I was determined and able to "come out of the closet" and acknowledge my Jewish origins.

To give father his due on the positive side, he was a loving and lovable man equipped with a work ethic equalled only by my mother's. Seared in my memory is his intermittently asked question, "What did you do today, to justify your existence?" The salience of that question in motivating my early interests and later career choice is clear to me, for I knew that what he wanted to hear in response was, not only that I had worked hard, but that I had done something helpful to others. What all of this has to do with my sense of myself as an aged therapist should be obvious to all colleagues who work psychodynamically. "What the mother says to you in the cradle remains with you to the coffin," to quote Harriett Beecher Stowe. And that goes for the father, too.

I had always wanted to be a psychologist--from high school through college years, to graduate school, never wavering, to this day. Mother adamantly opposed that wish, yearning for a daughter who would willingly wear white gloves and toy with the piano until "Mr. Right" came along and whisked her away. However, rebellious adolescence was firmly in place at that time. Mother's prudishness fueled my already strong resolve to study psychology. Not even the considerable professional obstacles could deter me. Nothing but psychophysics was taught in the graduate school at Columbia in those years, nothing for an aspiring therapist, and "Freud" was a dirty word.

My first very brief job was as research assistant (and translator from German) to Franz Kallmann, a psychiatrist at New York State Psychiatric Institute. Kallmann had recently emigrated from Berlin. He was reestablishing his investigation of familial factors in schizophrenia, begun fifteen years earlier. The study, "The Genetics of Schizophrenia," published in 1938, was groundbreaking at the time, because it was the first voice to speak in America against the dominant environmentalist climate of the time. I quit after three months, disaffected by Kallmann's authoritarian manner, as well as by my mother's insistence that I would be permanently scarred if I continued to work in a mental hospital. Kallmann's ways had put me too much in mind of the downside of my otherwise loving feelings toward my German-born, often authoritarian father, so that I yielded to her pressure without too much regret.

My first real job, in 1938, was as a psychologist-intern at a state institution for retarded girls. Later, I was a teaching assistant in the psychology department of an Ivy League women's college. And still later, I joined the Navy in WWII and became classification and selection officer at the "boot camp" for WAVES, as the women in the Navy were called then.

Let me proceed with the thoughts, feelings, and transference--counter-transference experiences that I have committed myself to relate. It has been a seering, yet rewarding, self-examination. My selfhood has avoided seeing myself as a maven of anything at all, certainly not of being elderly, despite the objective evidence that I am. Aside from the genetic good health that has permitted this blatant denial of reality to persist, the myriad interests that dominate my waking life have helped to shove it under the rug.

As analysts, we would be presumptuous to assume that we are immune to the fears and anxieties that sound a muted obbligato to the daily lives of many of our patients. Denial and avoidance are our most useful (and as often, overused) defenses. In my thirties at the time of my first analysis, aging was not addressed at all and was, indeed, irrelevant to the burning issues of that period of my life. At the time of my second, however, it was central to me, but anxiety-provoking to my analyst (or so I, at least, sensed it, maybe rightly, maybe wrongly). So, we colluded in avoiding/denying, a choreography that was ego-syntonic to us both. Serving under the same flag is my resistance to going back to her as my issues having to do with my advancing age begin to flare. Nor do I seek another analyst. Denial/avoidance are still in the saddle, for better or worse.

CRISIS: 7/24/94

This day gives me pause. My only sibling, a brother two years my senior, celebrated his 81st birthday today, the same day that my daughter marked her 44th. Who am I, kid sister or aging parent? To be kid sister feels fine now, though the feeling was once dismissive.

The many memories of those early days have become an inside joke to my brother and myself, as we comment acidly to each other about our aging selves--but, God forbid that we should relinquish the competing and one-upping that suffused our relationship in days of yore. Gone are those innocent days of childish "sibling stuff." And gone is the society that we, idealizing the past as elders are wont to do, remember as a homey place where "good" and "bad" were easily distinguishable. No wonder we use humor as a defense in our "papering over" of the depressing irreversibility of our aging.

How do elder therapists integrate the rapid, dramatic changes in society, mores, sexual freedom, and so on--or can they? And what are the effects on transference and countertransference of the subtle or not-so-subtle messages sent by unconsciously held biases that transmit a judgmental attitude? My mother's Victorian attitude toward any mention of sex-related behavior or even natural phenomena such as menstruation was extreme; the mere thought that I may have introjected some of that is anathema!

Often, I experience an uncomfortable sense that a younger patient hesitates to talk about his/her sexual life or about feelings of hatred for mother or grandmother. "How should I use my discomfort?" has been a question I've often asked myself as I quell the impulse to say, "Come on, now. Out with it! I may seem like a puritanical/nonunderstanding old lady to you, but I was there once and I haven't forgotten." Instead, of course, I dutifully probe for transferential material. My discomfort at the thought that my unconscious identification with Mama's prudishness may be "showing" is a bit surprising, as hers was not so far "to the right" of the dominant mores of my youth. The dean of the college I attended, Virginia Gildersleeve, was noted as a feminist before her time, but her attitudes toward sexual matters were not much different than my mother's and were generally accepted by the students of the early 1930s. Students were more concerned with being able to get through college financially in those Depression years and to be able to pursue the careers of their choice in a chauvinistic world than with sexual freedom.

The difficulties of my work with Frieda, a colleague much younger than I, is a case in point. With her, I felt the transference--countertransference choreography bounce around uncomfortably from the start, for the two and a half years that we worked together. Frieda and her mother still played out a love-hate relationship begun in Frieda's childhood. In the transference, I felt tempest-tossed between the two poles of her intense, unresolved feelings toward that mother. I was loved because I "was", transferentially, the nonjudgmental role model who turned a blind eye from the flamboyant sexual acting out that Frieda had begun in her early adolescence. Even more seductively gratifying, I was respected as a professional older woman, like her mother, whom she described as a widely recognized lawyer and political force in their community.

Frieda had emulated her mother's ambitiousness and had indeed rivaled her victoriously by completing her medical education and establishing a successful practice in a wealthy suburb. I had to be better than mother, though, by not disapproving of her sexual acting out while applauding her professional success. But, then, I had to be hated because I had other patients besides herself, to whom I surely devoted myself more lovingly than to her. Again, I was "Mother," the mother who had filled Frieda's childhood home with a constantly shifting group of foster children, most carrying court records of delinquent behavior, children drawn from the most poverty-stricken parts of the metropolitan area in which they lived. These kids were expert in their ability to devise ingenious tortures for Frieda, whom they hated because she was the mother's "real" child whom they yearned to eliminate, in trying to fill the black holes of their own neediness. Frieda's childhood pain has lived on, and I caught some unmistakably venomous glances that she bestowed on other patients whom she occasionally encountered when coming to or leaving my office.

In the end, hate won out. I was dismissed, ostensibly because I refused her request that I become her five-year-old daughter's therapist, instead of continuing our work together. I sensed her need to find the "good mother" she never had, for little Laura, in me, as well as her feelings about herself, not wanting motherhood. Her ambivalence, both loving and hating her child and her role in life, could be relieved if only I would take over the mothering. Thinly disguised, I felt, was her live feeling that I disapproved of her still-flamboyant sexual acting-out. I knew that she was right. The truly judgmental coloration of my countertransference shone through, despite my wish to be perceived as wholly empathic. I could not disguise the assault on my not entirely unconscious moralistic inclinations by her ever more lurid accounts of her current sexual exploits. Were my judgmental countertransferential reactions a function of my elderliness, identified as I unconsciously may have been with my prudish, Victorian mother and of the era of my own youth, or were they an ordinary 1990s response anyone of any age might have had to such lurid goings-on? In my metropolitan professional community, gossip about Frieda did trickle down to my ears and mostly from folks much younger than myself.

Frieda wanted me to be the "good mother," displaced to Laura, so that she wouldn't have to change and become a "good girl" by giving up her way of enjoying sex. She had tapped into my feelings of hopelessness and judgmental countertransference that nothing could change her entrenched pattern of living, that is, being sexually involved with one man for a brief period, while already searching for a new one who might promise greater excitement or challenge. So much for the "crisis" of the moralistic, judgmental underpinnings of my countertransference. It had been fostered by Frieda's unconscious projective identification of her unresolved need to provoke her mother's rejection of herself, and her rejection of her own daughter, onto me. Her unconscious recognized that I was, in reality, available to play out that dynamic with her.

A "crisis" feeling of my own making builds when I perceive similarities, particularly of age and life-experiences, with patients. To contain myself from remarking on them at salient times is something I have struggled with, not always successfully. In the case of Maura, whose obsessive need to accumulate, but never to throw away, has troubled her for at least fifteen years, I have been singularly unsuccessful in curbing the impulse to share our commonalities of age, professional status and obsessively tinged difficulty with throwing away useless objects.

Maura was my age-mate in her sixties when she started treatment in 1976. She was inconsolable because of her youngest son's drowning death the previous year. He, a college freshman, had disappeared while swimming from a jetty on the Atlantic coast. She reported that she scanned the newspapers daily for news of his body being washed ashore and searched every young man's face she passed on the street, out of her inability to believe that he had actually died. She told, with equal sadness and agitation, that her husband of thirty years had left her shortly after their son's death.

As she unfolded the story of their marriage, she described her husband as a profligate alcoholic whom she hated venomously but loved desperately. Such were Maura's dramatic skills that both feelings were convincingly depicted. But where was the compromise formation which would enable Maura to invoke reality and to accept, albeit neurotically, the death of her son and the abandonment by her husband?

Maura's resolution took the form of an enactment which defined the parameters of her private life. She became unable to touch any object in her home, let mail pile up on the dining room table without examining it, newspapers likewise, à la Collier brothers, until only a narrow pathway allowed her to move from the kitchen to her bedroom upstairs. No one was allowed to enter the house, and she experienced painful shame when plumbing and heating emergencies forced her to call for help. Bargain shopping binges provided Maura with transitory "highs," but once the parcels were brought into the house, they were thrown atop a growing heap in the sun-parlor, never to be opened.

Jumping ahead to the present, pack-rat tendencies that I recognize in myself and have shared with Maura have generated a fruitful transference-countertransference choreography, almost from the beginning to the present, fifteen years later. I've empathized with her inability to throw anything away and have confessed that I have often found myself enmired in ton-weights of paper, clothing and miscellaneous useless possessions that cry out to me to finally be "thrown." This I am able to do with gusto, when I finally reach my own idiosyncratic level of "intolerance." The difference between us has become an "inside joke," as we acknowledge that her inability to "throw" has its origins in tragic experiences of loss far more traumatic than any I can claim. Self-disclosure such as this sharing of the troubling pack-rat syndrome is far from a usual technique for me and can validly be critiqued as transgressing boundaries. Knowing this makes me a bit uneasy, but not uneasy enough to stop, as I observe Maura feeling new hope that she too may reach her own level of "intolerance" and find the strength to "throw." She is beginning to entertain the possibility that she may one day master the fears and the rage that have held her paralyzed. Transferentially, she sees me as an idealized colleague/grandmother, admiring my neat working environment, the like of which no longer seems unattainable to her.

Currently, she yearns to be able to invite her grandchildren to her home, gratifying their wish to see the house her older son grew up in, his room and furniture. The result of my self-disclosure, now intensified by her fervent wish to be able to open her house to her grandchildren may, finally, break the log-jam created by the massive losses that she had been unable to integrate. And I confess to the equally fervent wish to be successful in cheering her on, no holds barred.

The sharing of our being age-mates, first, then of loss, then of professional strivings and successes, and finally, of the pack-rat flaw have fueled in herself hope that she, too, can energize herself to "throw" and thereby become the true grandmother that she yearns to be.

Meanwhile, as the years have passed, talk of her younger son's death have wound down. However, she still shrieks her rage with ever-increasing decibels when she thinks of her ex-husband's defection and remarriage and of her two remaining adult children who had "betrayed" her by attending his wedding. "I was livid" is her favored introductory phrase to the compulsively driven recounting of each vignette that reinforces her sense of their betrayal. Her children seem, indeed, driven to provoke her rage by reporting to her chapter and verse of each much enjoyed meeting with their father and his new wife (whom she contemptuously referred to as "the bride"). Meanwhile, the hoarding behavior and the shopping binges have significantly diminished, and, in their place, the hope grows, tacitly, that the ability to "throw" will follow.

Surprisingly, none of Maura's neurotic enactments are reflected in her public presentation. She is always impeccably groomed and dresses with such taste that a cursory glance would suggest that her clothes were of the most expensive kind. Not so. She knows how to feign the current "look" perfectly, using clothes hoarded from earlier years. At the start of treatment, it was a different story. Her ex-husband's worn thermal underwear, unmended but clean, were her standbys for nightly wear. Was it her fantasy that she could bring him back to bed by wearing his underwear? Not unlikely, as Maura had frequently alluded to her enjoyment of their sexual relationship while despising him for every other aspect of his behavior toward her. "He would throw his pants pocket's collection of change on the floor to me, as all that I was entitled to, to feed the kids and take care of the house. I never knew when, or how much, to expect and I learned, almost gleefully, to make ends meet, no matter what." Thus, Maura turned her husband's sadism into victory for herself.

Frugality had been built into her character from early years because of her mother's almost despotic demand that the family present as a prosperous one, although the father's income was small. In Maura's marriage, that frugality and the role model that her mother had provided served her in good stead. I understood this very well, harking back to my own mother, who had mastered the same skills and had unwittingly passed them on to me via oft-repeated, fascinating tales of her own youth as an immigrant adolescent in a large family.

Just as surprising were Maura's professional status and functioning level. She had earned an MSW degree after her husband's departure and holds the top position today at the agency where she was hired ten years ago, after graduation from social work school. Her pride in having achieved her degree resonated countertransferentially as I thought -- and felt -- back to my own academic history. After an intermission of 17 years and after having married during the war and having my five kids, they were all, finally, in school. I went back to graduate school and completed my degree in social psychology in 1966. Then, seven years later, my husband died, he who had encouraged me to return to school and finish my Ph.D. Though my own unresolved grief had little of the ambivalence that Maura expressed, her crying sense of loss echoed with an intensity that enhanced our working alliance.

As Maura's treatment progressed, there were significant changes. Some repairs on the deteriorating structure of her house were made; some trash bags were filled with papers accumulated over the years and placed at the curb. Binge shopping ceased, and some of the unopened bags were examined. The positive features of her relationship with the "disloyal" children reappeared.

Treatment stopped ostensibly because Maura's insurance coverage ran out. Now she calls me periodically just to chat, but particularly to tell me of some momentous happening such as her ex-husband's death. Hoarding behavior is never mentioned. Maura had occasionally acknowledged, over the years, her fantasy that the drowned son and ex-husband might come back, so long as she kept everything in the house unchanged, and it was my sense we both knew that the insurance issue was a cover-up for her fear that, if she continued to gain emotional strength in therapy, she would finally have to relinquish the fantasy.

My 20-year working relationship with Will is different in every way from that with Maura, except for a similar crisis feeling of my own creation, when treatment continues year after year and the gains, though palpable, have required so many years to come about. How to reconcile more than 20 years of treating the same person, with self-imposed, but admittedly unattainable, standards of being Dr. Super-therapist? "If I leave it to him, we will go on forever. I may want to retire before Will is ready to retire me." Thus mutters my sometimes tyrannical superego, as I ruminate over the fact that he and I began our work together when I was in training. He was the perplexing patient I brought into supervision those many years ago. Then, I felt inadequate to treat this person, years younger than myself, who could engender such a tidal wave of anxiety.

I approached each hour with Will as a potential crisis. I waited, muscles tense, for the critical, cynical, intrusive observations with which he invariably started every hour. The saving grace, reducing my anxiety to a tolerable level at that earlier time in my career, was that he would "dissolve," as he put it, never more than ten minutes into the hour, sinking to the floor. From that position, for the rest of the hour, would come quite different messages, spoken softly. There was desperation, a recital of failures, and verbal and gestural attempts to describe his sense of inner chaos. I could empathize with that, recognizing my own tendency to "dissolve" and feel weak and hopeless when things I cared about didn't go right. A bit guiltily, I realized that I felt more comfortable and free of the anxiety with which I reacted to Will's critical sallies, when he was indicating his deep-rooted insecurities. I wondered where this narcissistic, unempathic countertransference might lead the treatment. Certainly not in a positive direction.

Most difficult, for me, was Will's ritual "parting shot" in those early days. At the end of the session, as I would rise to leave, the arrangement of the doors necessitated my passing the chair he sat in. He, instead of rising, would remain seated and reach out his hand in a surreptitious gesture, with the obvious intent that I should grasp it. I never acceded and, just as ritualistically as his entreaty/invitation, would counter with regret that we couldn't discuss his behavior now, since our time was up but must do so next time. At the beginning of the next hour, discussion of hand-holding was often relegated to the back burner because more urgent needs seized precedence.

The years pass, my confidence grows, anxiety diminishes. Transferentially, I feel myself less and less the hated parent. "Aging has its advantages," I say to myself, as it is my less anxious reactions that seem to have quelled Will's impulses to utter his wounding criticisms. We enter a phase in which a part of each hour is devoted to problem-solving, at his request, because here-and-now dilemmas have loomed. This new way of my being "there" for him has unveiled some windows of understanding not visible before, anent his feelings of newly owning a self and of his relationships, at home with his lover and his children, in the work-place with colleagues and bosses. There is no grimacing or outreaching hand, wanting to be held. Sitting in the chair is the preferred posture during problem-solving times, with feet on the floor, both literally and figuratively.

Will's marriage was floundering, his children were contemptuous of him, and he felt unable to focus on any one of the many career lines that offered themselves to him. He had many gifts: music, art, science, writing -- any academic field he would elect to focus on with his multi-faceted intelligence. Fragmented, he dashed from one project to another. Each time, there was the promise of success at first, but each time, he failed to complete the venture. Another interest would intrude, offering irresistible fascination. And I, inexperienced and anxious, was breathing hard to cope "therapeutically." How to contain the roller-coaster countertransferential feelings when he projected into me the hated bad parent and the loved good parent, antiphonally, in the space of minutes, with chameleon-like ease?

Most anxiety-provoking of all was his habitual parting gesture of holding out his hand sidewise, that surreptitious enactment that, no doubt because of my sense of powerlessness to control or to make use of in the treatment, persisted for many months. Regardless of the fact that I never grasped his hand or of the number of times that I asked him to talk about the feelings he wanted to express by way of the gesture, he seemed unable to give it up. "My needy stuff," he called it and showed extreme embarrassment when I pressed for discussion, rather than enactment. Discussion and understanding did ensue, finally, though his embarrassment at trying to put his feelings into words endures to this day.

But for me, "crisis" feelings rise again, changed in nature, but not in intensity. "How long can this go on?" was the searing question to myself, as we entered our eighteenth year. What was worse, the "needy stuff" that had whipped up my anxiety level in the early days was coming back. He wanted to hold my hand, and he wanted to sit on the floor next to my chair. "The needy stuff" takes center stage again, as Will points out with intense embarrassment that he must confront it or he will never get well.

Only this time around, there is an important change. I'm not anxious. I decide to try taking his hand. I let him know that where he sits is his choice. We talk about it all, not easily for him, but still more talking than gesturing and grimacing. He seems able to hear me when I keep saying that I want to understand what he is feeling and when I throw out some hypotheses (a.k.a. genetic interpretations) about early experiences of trauma, which might underlie his current painful feelings. We can speculate about what he is yearning for in his feelings for me.

As for my countertransferential feelings and, consequently, my "therapist" behavior, I perceive the sea-changes that have crept up on me in the 20 years of work with Will and search myself for understanding of the changes. Was it the mellowing that, granted, inevitably comes with age? That's descriptive but not explanatory.

Do patients' transference manifestations change as the therapist ages? And, conversely, do differences emerge in the countertransferential feelings that one had experienced in earlier years of work? Clearly, the answer is "yes" to both questions. Issues of separation, of death and dying, and of the unpredictability of life become increasingly salient, emotionally and realistically, as both analyst and patient age. Dramatic changes have taken place in the lives of both Will and another patient of mine, Jodie -- changes wished for, as well as those reflecting incerases in anxiety, as the termination of the relationships between themselves and myself became inexorably closer. Would I be the agent of that termination for reasons of personal decision or, perish the thought, because of my illness or death? Or would they take control and make conscious plans for termination, with or without my participation in the planning? Imponderables, but clearly present in the flow of associations coming from the couch.

As I write, my eye travels to some newly typed pages that I was given an hour ago. Interesting point-counterpoint: the disheveled, fragmented Will of twenty years ago whom I have been describing just handed me the abstract of his Ph.D. dissertation. He is still the same person, but no longer disheveled, and eminently able to focus on tasks, complete them, and relate to peers and authority figures with enough effectiveness and presence to put him near to the completion of his Ph.D. and to be in the running for three university teaching positions. Many of my own memories of the seven years of foot-slogging that it took to finish my Ph.D. and then, the seven years more of post-doctoral training, were with me again. Maybe Will and I won't have to go on to the 21st Century after all, but I'll miss him when he "graduates."

A clutching, seemingly uncontrollable need for me, to see me, to be reassured that I care for them has suffused my work with both Will and Jodie, an African-American patient whom I have been seeing for the past ten years. My aging has introduced an ever-increasing component of fear, fear that I am ill, that I will die, that I will stop working. Will's aging, as well as mine, has worked its own effects on the twenty years of our work. But how can I separate those reality-based outcomes from those of other fortuitous life circumstances and from the therapy itself? Impossible.

Will yearns for me to fill the "black hole" of his need for the loving mother he never had, for the bodily closeness of infant-mother intensity. He fears the unacceptable sexual overtones of these feelings almost as much as he fears that I will die or leave him because he is "repulsive" to me and has hurt me beyond my endurance.

Pre-oedipal issues focussing on their early significant relationships are the dynamics that underlie Will's and Jodie's difficulties. Will had given graphic evidence of having been rejected by his mother as far back as his excellent memory had taken him and even more graphic accounts of an older sibling's being preferred.

Jodie is just as afraid that I will die, but the dynamics are very different. Her mother would have been the same age as I, had she not died 20 years ago. Such were Jodie's conflicting feelings for the mother that she felt unable to enter the room as her mother was breathing her last. Afterwards, she had searched fruitlessly, over and over, among her mother's things for some message that her mother had loved her. I sensed my ardent countertransferential wish for Jodie that she had been able to repair her relationship with her mother before her death and reexperienced my feelings at the time of my own mother's death, when our feelings for each other had come full circle to the loving closeness that had existed during my latency years.

"You're allowed to love her." This is what I felt like saying to Jodie. After monumental efforts spanning all ten years of our work together, to help her work through her hateful feelings toward her mother, she was finally able to whisper, "But I loved her." With that, she quietly recalled memories of good times, never before mentioned, when mother had read poetry to her, had taken her shopping, and more, which told of the benign side of the relationship. And my feelings, sensing the striking turnabout in her? A kaleidoscope of gladness that she was finally able to contain and express her loving feelings, changing to anxiety as I anticipated the long-awaited negative transference. How would I handle her inevitable anger directed at me -- I, who in eighty years of life have struggled against a seemingly unquenchable need to be liked. Would my unconscious, "sneaky" ways of undercutting others' anger be so powerful that they would derail Jodie's progress toward health, signalled by the eventual resolution of her transference neurosis? A crisis is building in the current stages of the treatment.

Again, echoes of myself and Mother ricocheted against the walls of memory for me, as I reexperienced the delights of travel, theatre, concerts, opera, and the like when I was boon companion to the adventuresome "joi de vivre" mother-self that she was in the days of my childhood. Only later, in adolescence, was I to feel the anger toward her when she, with thin-lipped disapproval, tried to derail my aspirations to become a psychologist.

I remembered vividly my amazement one particular day, when I was a college freshman. Mother had said, as she left the house very early one morning, "This is the day Aunt Margaret and I are going out to Long Island to visit Old Lady Bernays." I was accustomed to this yearly event and had never inquired how this unknown old lady fitted into her life until she came home that evening with a granny-square afghan draped over her arm.

"What's that?" I asked.

"Old Lady Bernays made it for me," was the answer.

"And who is this Old Lady Bernays, anyway?"

"Oh, she was Professor Freud's sister, and we got to know her on the boat when we came over from Vienna."

"What!" I shrieked. "Freud's sister?"

With disdain came the response: "Yes, Professor Freud. He destroyed the age of innocence."

It was this exchange with my prudish mother that came to mind when I experienced the haughtily scientific anti-Freudian attitudes in my early student years. The loving, but overprotective and possessive, sense of herself as a mother determined a peaceful, harmonious relationship between us through the latency years. Then came adolescence, when those same qualities created the battleground for my own struggles to individuate. The dividend for my development as a therapist was a deep understanding of the centrality of the quality and nuances of the mother relationship.

Jodie had me helplessly locked into "good mother," only rarely -- and then indirectly -- expressing her positive feelings and intense loyalty to that devaluing, critical, insensitive mother whom she had hated. I feared that I had fostered treatment impasses time and again by failing to focus earlier on her compulsive need to tell of any instance in her day-to-day life when she had received praise or had been given evidence of being liked by anyone. The other side of that coin was an equally persistent need to "undo." She felt inadequate, fraudulent. She knew nothing. How could she pretend to be an aspiring therapist? How often have I, too, had feelings of inadequacy, incompetence, blundering? Empathic countertransference pressures me to reassure; holding back is not easy.

Jodie's mother had rarely, if ever, praised her, as she remembered her childhood. But often, her mother had indicated that she suffered from exhaustion because of the grueling daily grind of teaching third grade classes, a job she needed desperately, as a single black parent and lone breadwinner. I, too, remembered an "exhausted" mother who could not be disturbed when she took her ritual afternoon nap, but she, unlike the mother of Jodie's first ten years of life, was equal in partnership with my benign father in creating a successful business. I bathed in countertransferential joy when Jodie described the positive change in her own life when her mother remarried, having found a man who fathered Jodie as lovingly as mine had dealt with me; however, Jodie still persisted in relating in minute detail every bit of positive feedback she received.

Finally, in a recent session, I had evidently "had it," countertransferentially, and had remarked on this need of hers, as I had done many times, but this time with a new, more urgent voice. Her response was equally urgent, joining me in asking "why," as though she was hearing the question for the first time and hadn't a clue as to the answer. From this, after a brief silence, came an avowal of her feelings of being disloyal, of betraying her mother when she spoke critically, angrily, or hatefully of her. After another pause, she gave an accounting of the good times, spoken with the somewhat hesitant voice that evoked from me, "You're allowed to love her."

And so it transpired that she was finally able to say, "But I loved her," by my irritable inflection. Now, looking back, I sense that my irritation stemmed not only from Jodie's manifest behavior of needing to "show and tell" every indication of her goodness. Underneath, I was irritated at her because she wasn't as "good" as I in realizing how much she loved, as well as hated her mother before she died, as had I. However, I was relieved and gratified that I had restrained myself from self-disclosing, to the end result that she was able to do the work of uncovering her positive feelings for her mother unaided.

It gradually came clear to me that when I asked why she always seemed to have to tell of every experience of being praised, my voice had conveyed irritation, ergo Jodie's ability to access her "guilt" at having bad mouthed her mother to me again and again over the years. Something ineffable had taken place in the interpersonal and intersubjective space between us that was enabling. The "splitting" between myself, the transferential "good mother" and the real mother's "badness" could begin to be healed, and it was the countertransferential irritation that my voice conveyed that made it happen.

Another aspect of Jodie's feelings came to mind as I pondered all of this, namely its meaning in the transference -- her thinly disguised feelings of envy and rivalry with my daughter, whom she had found out about in the "small world" in which I conduct a suburban practice. It became suddenly clear that her apparent compulsivity in having to relate even the seemingly most trivial feedback that she was good, bright, or competent had a "sibling rivalry" connotation. She had shown that she yearned to be my daughter many times in many ways. Telling me how good she was, how well-seen by others, served her need to say, "Please love me more than you love that daughter of yours." Often, I sensed an angry tone of voice when the jealousy was expressed, particularly when she had found out that my daughter was visiting. "She can take care of you now." The dividend for the analysis was that the negative transference was fueled by her anger, signalling a break in the thick "ozone layer" of her "good mother" transference neurosis.

The crisis that is aging is not sudden. It creeps up on you or, better said, comes full circle at you, gradually. I had worked with Hannah ten years ago, when she, a widow in her mid-seventies, had come for help in making crucial decisions. Should she sell the comfortable home and office combination that she had lived and worked in, as wife and her physician-husband's lab assistant and office factotum? Should she move to a mid-western city, to be with her only close relative, a sister who urged her to do so and who, she felt, needed her? Having no children, she was free to choose. Or thought she was.

Hannah was an intellectually and artistically gifted woman who generated enormous feelings of discomfort in me, as she circled endlessly around and around, debating the pros and cons of the issues that, she insisted, demanded quick decisions. A classic example of projective identification perhaps? Cold comfort, I moaned then, as I helplessly struggled with my countertransferential discomfort while she enjoyed yet another trip around the track of indecision. Finally, she decided to visit her sister in Kansas City. The sense of anomie and dislocation there was all she needed, to come to a firm decision to return to New Jersey, which she could then acknowledge as her real home.

As Hannah unself-consciously enacted her inbred "Viennese-ness," she generated an overpowering countertransference stemming from the anti-Viennese-ness of my own Viennese mother. My mother abhorred the thought of being identified as one of "them," with their superficiality, insincerity, and manipulativeness (as she characterized "them"). Her accent, when speaking faultless English, was easily identified as European, but not as Viennese or German. This was an example par excellence of her determination not to be identified as Viennese. American is what she wanted to be, with very little acknowledgment that any part of her identity was lost by denying the value of the past.

Meanwhile, I, firmly designated by her to be her constant companion and helper, became the parentified child who took care of her as she coped with the physical (very probably psychosomatic) ailments that signaled the price she paid for her denial of the past. The wisdom of hindsight tells me that the early loss of her mother, when she was 16, newly immigrated, and faced with the imperative to become a wage-earning adult, generated the neurotic need in her to tie me to her side. Her fantasy, as I piece it together from many things she said, was that, if only she had been constantly at her mother's side and had taken care of her, her mother would not have died. And so, consequently, I was elected to the office of doing and being where she had failed, so that she might succeed in staying alive.

Fast-forward to the present: Hannah, now in her mid-eighties, calls me and wants help as she faces crucial decisions. This time they revolve again around a multi-faceted issue: a serious heart ailment undermines her confidence in living alone. She has already experienced the terror of suffering a heart attack and finding herself on the floor after an indeterminate period of unconsciousness. Should she, can she, remain alone in her beloved apartment, ailing as she is and fearful, not only because of her illness, but also because of the dangers that threaten outside her door? The apartment house in which she lives, once the most luxurious, now sits isolated in a high-crime, inner-city neighborhood. 'Round and 'round she circles once more, around the track of indecision, and once again I moan with the pain of feeling impelled to trot right alongside her as she circles.

I find that working with Hannah requires constant vigilance for me, lest I be seduced into taking care of her: driving her to inspect various retirement communities, having dinner with her, intervening with friends who treated her badly. Again, my "parentified" relationship with my mother fuels wariness, negativity, and anger as I squirm out of unprofessional entanglements. Underneath the pain, I sense intimations of my own mortality, the excruciatingly painful decisions I, too, may be forced to make.

A very different relationship developed between myself and another age-mate patient, Lucie. She, also a European woman and a professional musician, had endured losses as traumatic to her as Hannah's. The recent loss of husband and mother, almost simultaneously, were the issues which brought her to my office. The crying spells, insomnia and general dysphoria from which she suffered diminished and then disappeared as she worked through her disabling grief.

However, she made no move to terminate and willingly answered when I asked if there might be other issues she wanted to explore. What then transpired was her candid revelation that she yearned for a new sexual relationship that would be more gratifying than the one she had endured with her husband, with whom she had often felt somewhat martyred because of his disinterest in sex. Sexual feelings were very much alive despite her age, she said, shooting me a mischievous twinkle. As we discussed the realities, both of her sexual "aliveness" and of the probabilities of her finding the relationship that would fulfill her yearnings, I found myself experiencing intense empathy. We exchanged grins as we realized that sexual feelings were alive and well, despite our age. Memories of events from a few years earlier in my life, as well as the knowledge that I shared her yearnings, flooded into the forefront of consciousness. I had written an account of that period, which occurred a few years after my own husband's death.

I had started to work with a new patient who had been referred by a colleague with whom I was not personally acquainted. The patient turned out to be the colleague's father. Depression, bordering on clinical depth, had been exacerbated, three years after his wife's death, by his felt need to sell his large suburban house in which he now "rattled around" alone and to close his laboratory and retire from an active professional life.

I had felt myself react positively as I ushered a tall, nice-looking, well-spoken gentleman from my waiting room into the office. "Hm, not bad, and he seems to be about my age," I muttered to myself.

After the third session, I recognized my discomfort at the situation. The sessions had been going well, too well. I caught myself indulging in fantasies and waking from a few dreams that told me unmistakably that my hormones were not dead. My patient acknowledged similar feelings, and it was agreed that patient-therapist work was not going to "work." There ensued a romantic flurry, which rapidly went downhill. I had come to resent his intimations that I was "too independent" and his tacit agreement when I suggested that he wished for a nurse more than a partner. So the final coup de grace was delivered with regrets but not despair, and the relationship ended.

Lucie's story developed very differently than mine -- an almost Class C "Boy Meets Girl" movie ending. She met her knight in shining armor; he adored her on sight; they were married within a few months, and his sexual expertise was dreamily satisfying. Countertransferentially, as I followed the idyllic course of Lucie's romance, I heard the words "hope can spring eternal" running through my head. And after those words, "If at first you don't succeed, try, try again."

As I hear these words, other not-so-wee-small voices overtalk them in my head. "Would I really want to give up the lifestyle that I've become comfortable with?" Over the 20-plus years since my husband died, I've had myself alone to take care of. Being alone did not necessarily connote loneliness. On the contrary, children, grandchildren, friends and, above all, career demands readily filled days and evenings. Narcissistic proclivities were nourished by the fact that I did have only myself to take care of. Men who were interested in women my age became scarcer and scarcer. Those who were out there seemed to need nursing more than companionship. "Thanks -- but no thanks" rings in my head now. I'll stay with the memories of the husband-friend and forget about scanning the scenery for a replacement. And what happened to the still-live sexual energies? They seem to have faded before the urgency of all the other fulfilling contributors to my emotional life.

Our work together has ended, though Lucie still calls occasionally to fill me in on her life and to show that she values keeping our relationship alive. I am also cognizant of the value I received from our work together, which enabled me to reexperience my later-life romantic episode and lay it peacefully to rest.

I am old. I am not even a member of the young-old by today's classifications that differentiate elders as they occupy one or another of the three categories of young-old, middle-aged-old and old-old. That is the truth that I seem endlessly able to deny to myself, but frequently, I am ready to acknowledge that "my youngers are my betters." Many that I rub shoulders with are, to me, "my betters" and would be role models to me in one aspect of life or another, were they younger or older.

Reality must break through, finally. I am painfully aware that, even in the writing of this account, I am dependent on the competence of three younger women, to keep me "on track": first, my own daughter's best friend from earliest years, who is today a teacher of writing; second, my daughter herself, whose insights are rapier-sharp; and third, the editor of this volume, an analyst herself. Were it not for these three, would I be able to organize my thoughts in logical sequence enough to be readable? Would I be able to muster the objectivity I need to focus aspects of myself that are essential to the narrative truth of my writing? And, finally, could I restrain myself from the endless, garrulous digressions that are, stereotypically, a characteristic of aging? Not likely, is the answer. My dependency on "youngers and betters" grows with my years, clearly. Dependency is a thought I abhor, and yet I bask in it, knowing well that the other side of the coin is that, with it, I can continue to function as independently as I do.

Denial may again be responsible, as I realize that I have left the impending crises most salient to the aging analyst for the end of this chapter, namely, separation, loss, and death. Major issues related to the inevitabilities of life pervade my work. No week goes by without engagement of one or all. They have become increasingly manifest, as my own aging has become more visible. Countertransferentially, I have become more sensitively attuned to indirectly expressed, latent content and affect arising out of these issues, coping as best I can with my own defensive efforts to deny their importance, if not their centrality.

Often, the anxiety generated by patients' emerging awareness of the urgency of these issues is palpable, both with respect to their own histories and, in the patient-therapist dyad, their fear of hurting me by expressing these anxieties anent my own obvious age. Witness the sometimes laughable reactions of patients if I so much as cough or clear my throat. In tones of anxiety they ask, "Are you OK?" Cancelled sessions and vacations, when announced by me, are circuitously inquired into, in ways different from earlier years, to seek reassurance that I am not ill. Much as these occurrences generate "grist for the mill," they also position me face to face with my own anxieties about the inevitable diminishing of my abilities of sensitively attending and of cognitive functioning. Referrals diminish, but, even if they didn't, could I, in good conscience, accept patients whose issues and potential suggest long-term analysis? Do they even seek me out? And if they don't, is it my age, or the recession, or managed care, or all of the above?

I recognize that I was able to come full circle as I finally achieved my original goal, training in psychoanalysis, in the NYU post doctoral program in psychoanalysis and psychotherapy. What did I care that one of the admissions interviewers told me that he would not have recommended my acceptance if there had been a larger number of applicants to the program? His reason, stated bluntly, was that it was of dubious value to invest so much training in an individual who had so few years left to practice the learnings. (I was 58 at the time.) Did he notice that my nostrils flared as I tried to appear smilingly impassive while taking in his message? Now, more than 20 years later, I am still happily anticipating the improvements in my work to come.