Psychoanalysis of Old Age Three Clinical Vignettes

More than a century after the creation of psychoanalysis, since Freud firmly established a connection between the pains of society and the psychic sufferings of our patients ² , we find, in echo, an unexpected rise of a new clinical category: women and men, beyond their sixties, who are beginning an analysis.

« Ai-je ainsi le choix entre mourir et me “réaménager” ».

Sandor Ferenczi, Letter dated 2 October 1932. ¹

The interest in psychoanalysis of old age follows, in general, the same evolution as that of the analytical work with children. Still marginal not a long ago, this growing attraction to the discipline of old age responds to changes in the social field that make it worthy of study. The emergence of a “fourth age” due to the lengthening of the life span, the inevitable playful dimension and the offers of leisure activities which accompany it, making the previous age group a significant economic market share, arouse in the collective thought a “return in grâce”: the happy “third age” from which sexuality is not - or no longer – excluded. Psychoanalysis can then invest the clinic on the theoretical basis stated in his time by Karl Abraham and according to which “the age of appearance of the neurosis has more weight for the outcome of psychoanalysis than the age reached at the time of treatment”. ³ Or we can rely on Ferenczi's reflections in his article “To understand the psychoneuroses of the change of life”. ⁴

The contemporary perspective of hyperconsumption installs consumerist priapism - to maintain awake the consumer's desire - where this latter “seeks less to occult the death than to fight against the dead times of the life”. ⁵ Our time reprograms a rehabilitation of the declining ages whose underlying psychological mechanisms are based on Freudian sexuality: “novelty will always be the condition of enjoyment”. ⁶

As a sign of the times, the three female vignettes presented in this study testify to this cultural normality: Being a product of a generation where, as they would later explain on the couch, we “don't talk about that”, these women decided in their “old age” to consult and, past the apprehensions of a first interview, start work on themselves.

Ambivalent relationship to death

Let us briefly present these cases. They are three women, two in their seventies and one who is approaching it. What are they looking for on the couch? None of them has any serious organic pathology, or to put it in another way, they are in good physical shape ⁷ . During the sessions, age-related diseases will hardly ever be discussed. For this, they visit “regularly” their primary care physician. One likes to travel by train and, with an alert stance, walk up two flights of stairs to my office. The other does not mind driving two hours, “listening to classical music in her car” to come sometimes three times a week, to her sessions, occasionally drinking a glass of champagne before starting. The third is still working part-time for economic reasons.

Their preoccupations are essentially of a psychic nature and their physical relationship to their finiteness - as far as it can be - seems accepted. And this, despite the “relationship with death”, which lacks frankness and often falls into narcissistic ambivalence when it comes to that of the other, “a great pleasure which is not to be neglected in old age”. ⁸ In his countertransference, the analyst could be tempted by this last perspective not only to distance himself from the spectre of destruction embodied by his analysands. But also to circumvent “the difficult problem” that death poses to psychoanalysis: “an abstract concept with a negative content, for which no unconscious correspondence can be found”. ⁹ None of this for these patients who apply, without knowing it, Voltaire's precept addressed to the Marquise du Deffand: “I urge you, as much as you can, to enjoy life, which is not much, without fearing death, which is nothing”. ¹⁰

If we needed an extra argument, we could add that their “demand” is not regarding their “old age” but their early childhood: What these women have in common is that they “want to solve a problem”, “to put something straight”, “to elucidate an enigma”, that of “a whole life”. We do not feel that we are in what is called a “neurosis of involution”. ¹¹ Rather tidying up, cleaning, storage: for proof, files, clothes and objects belonging to the deceased parents and kept until then, are “sorted, classified, thrown away.” Without any sentimental outbursts.

The first one, referred by a psychiatrist, aged over seventy, comes to consult to “solve a problem that has haunted her all her life” and that she wishes to “clear up.” Her education and environment did not allow her at the time to evoke it. Her husband was deceased for several years, which rules out the idea of a triggering phenomenon for the analysis. She feels able to take this step to put an end to what she calls a “mystery.” Since her childhood, dreams or nightmares make her feel an “oppression on her body, a human form lying on her and pressing her while she sleeps.” When she does not wake up with deep disgust, she recurrently dreams of “blood-stained sheets.” She has always endured these dreamlike events without revealing anything to her parents or husband. “Free”, she intends to “find out” if anything “really” happened that would implicate her father or an adult in her family's circle. Or if it is a question, hypothesis which she approaches from the first session with relatively controlled guilt, of a “sexual fantasy of her own.” A “dream of anxiety” of which Freud has precisely defined nature. ¹² Her analysis takes the form of a “criminal investigation” mixing the clinic of the ghost and the problematic relation of being to knowledge and to the truth: the contradictory challenge of an individual psychic “libération” knowing, on the one hand, that “Memory and consciousness are mutually exclusive” ¹³ but that, on the other hand, “nothing that we once possessed in spirit can be totally lost”. ¹⁴

The second vignette proceeds from a similar articulation: born in France during the Third Reich occupation, this woman whose blood type does not correspond to that of her parents, whom she took care of until their death, “knows” therefore that she cannot be the daughter of her social father. Letters seem to attest to the latter's difficulties in procreating a long time into the marriage. At the same time, the mother finds herself pregnant when her husband has just returned, significantly weakened, from a prison camp in Germany. It is once again the relationship to the historical authenticity of the subject that is questioned in this analysis because biological certainty in haematology exhausts, according to the specialists, any doubts in the reality. But certainly not in fantasy. This is evidenced by the dimension taken by the latter in the family romance: the supposed adulterous affair of her mother with a German high-ranking officer, and the incestuous reprisals of the father during her prepuberty, will plunge the teenager into a severe anorexic episode. With a remarkable professional and political career, the patient oscillates between salvific sadism full of social recognition and a threat of collapse - with suicidal ideas - by extreme abandonment.

The latest analysand, a woman in her late sixties, came to analysis after a triggering event: the departure from the family home of her unmarried son in his thirties who suffered from obesity. The latter settled, to the great displeasure of the mother who wondered - and asked him about “the one who would one day take her son away from her” - in the same “maternal” building with a fifty-year-old divorcee. The overweight of the son, which the mother had tried to remedy by imposing on the child, at first a draconian diet, and then surgery, will have found another environment of adiposity and socio-psychological indetermination thanks to which he can undoubtedly escape, besides his invasive mother, to his anguishes and dilute, drown even his identity, even his sexuality.

Analytical work with the elderly

How to welcome these requests? Should we only approach these three clinical cases from the angle of old age and analytical technique? Many analysts have already written about working with the elderly. What do their authors say about it? Gallery of portraits.

“Psychoanalytic work is possible with older people” ¹⁵ , tells Bernard Brusset. “But with certain precautions”: according to him, it is necessary to avoid “inducing too much regression (for example in a lying position), too much silence.” The technique is closer to psychoanalytical psychotherapy. Debatable statements, as we shall see. “The idea of accepting a request for analysis beyond 50 or even 60 years old is no longer considered risky insofar as today's society allows people of this age to hope for a second or even a third sentimental or parental life” ¹⁶ , adds Claude Dumézil. According to Raymond Cahn: “It occurred to me, without my even realizing it, that one can do excellent work at any age and that the degree and quality of resistance is hardly a function of one's birth date. Thus, I was able to dramatically reduce life restrictions in patients who were over 60 years old”. ¹⁷ In his “Treatise on Pedagogy”, Immanuel Kant dismisses in one sentence all these oratorical precautions: “Socrates, who called himself the midwife of his listeners' minds, gives us in his dialogues, which Plato has somehow preserved for us, examples of how to lead even people of a mature age to draw certain ideas from their own reason”. ¹⁸

Let's continue our modest inventory. These three cases take us far beyond questioning genital sexuality, the “Torschlusspanik”, the panic fear of the extinction of desire as evoked by Michelle Moreau-Ricaud in her explanation of Balint's text on “ageing”. ⁹ None of these three analysands recalls this propensity, due to old age, to withdraw from the world, this “Entrücktheit” according to Balint. It would even be the opposite: regular sessions, very invested. We are also moving away from the cases presented in a fascinating review in the “Revue Française de Psychanalyse” where the elderly analysands would have “suddenly entered a period of decompensation” ²⁰ with a clinical situation “almost traumatic, made of depression with anguish, suicidal ideas, insomnia, sometimes anorexia.” Nothing like that in our examples. It is, therefore, not a question of therapeutic care, of support in the face of the apprehensions of a programmed disappearance for these educated, even highly qualified patients. They have not yet become the “limit of their bodies”. ²¹ Beyond their menopause, these women are certainly not yet at the point of death, like the ultimate accompanying therapies outlined by Michel de M'Uzan. ²² What worries them more is how far they have to go before this disappearance. We will see that this is not nothing.

If it is not a question of “death” stricto sensu, we cannot remove from our minds the intimate conviction that these three cases involve something vital: the “request” is explicit. It surprises by its conciseness. The imperative need for a threshold to be crossed through an “other” listening intended to prune, de-embarrass, simplify a re-elaboration of their truth, even a distancing from it. If in the beginning, it is the question of knowledge that is at stake, the analytic work decenters, unsticks, deviates this interpellation towards the psychic integration ²³ : a process of reorganization of advanced age of the life takes place then. Finally, the questioning of these analysands follows Ferenczi's shocking formula: “a question that remains unanswered: but why was I brought into the world if they were not willing to welcome me kindly”? ²⁴ Unusual, these “calls” testify of “these relations of the displeasure, the pain and the anguish” which “risk to teach us something on the relation of the psyche with the body”. ²⁵

Return of anxiety

To understand it, we have to turn to other theoretical and clinical horizons: “there is a becoming, but this is something else”, Annie Anzieu explains in a way that is still too sibylline about elderly patients in analysis ²⁶ . Perhaps we should come closer to the definition of “pain” as it emerges, once again, in Ferenczi: “the revolt against the painful reality” leading to what he calls the “way of acceptance”. ²⁷ We associate with it an obscure note by this brilliant author entitled “to be dead, to be a woman” ²⁸ about “women's intuition”: “that the moment of dying, when the inevitability of death, perhaps after a hard fight, is recognized and accepted, is accompanied by this omniscience out of time and space”. We indeed feel the need to question a “beyond” of the climacteric, an intrusion in a “great age” to try a non-sclerosing conceptualization of the essential cycles of life and this, from the concepts of the limit, the drive and the anguish. This triple articulation is not denied by a classical analytic approach: “One could consider that one of the main objectives of a ‘gerontoanalysis’, would be to introduce limits and order in the overabundance of associations which encumber, overwhelm the patient and which at the same time, on the other hand, nourish him, retain him, enrich him, flesh him out”. ²⁹

In the special issue of Erès Edition, Alain de Mijolla discusses, as if echoing Annie Anzieu's sentence, the “becoming of another freedom” ³⁰ : Wouldn't it be this very freedom, this space that solicits an ego, henceforth likely to be overflowed by this announced defection of limits? We make the hypothesis of an ego freed, partly, from the tyrannical super-ego: “At my age, I don't care anymore” explain these patients whose entry into analysis testifies to their absence - or at least their attenuation - of existential prejudices. Would it not, therefore, be on the side of the impulsive Id that the essential is played out? If “genital physical sexuality is no longer of their age” as these women express it with rare ease on the couch, this does not mean an absence of psychic sexuality: to be retired is to put oneself on the field of enjoyment. In Spanish, “retired” does not exist; one speaks about “jubilados”. ³¹

We have the feeling that the Ego of these patients does not have to fight anymore as it did throughout their life: the advanced climacteric calls into question, but without abolishing it altogether, the servitude of this instance towards its three masters. It reassesses the “threat of the three dangers”: “the external world, the libido of the Id and the severity of the Superego”. ³² Doesn't analysis question this “capacity of the Ego to reshape itself by reaching compromises between the three requirements of the Id, the Superego and the external reality” ? ³³ This trend is all the more marked because previous conflicts could not be sufficiently dealt with or worked out. “What can I do with this freedom I have been subjected to when I have devoted my life to others,?” asks one of the analysands.

We think we are touching the heart of the matter: what is the nature of this anxiety perceptible in our three patients? Let us read Freud again on this subject: “all anxiety is in reality death anguish”, he affirms in a paragraph of “The Ego and the Id”. ³⁴ And to specify: “my opinion is that the anguish of death is played between the Ego and the Superego”. But as usual, Freud nuances his considerations: “The anguish of death, whose domination we undergo more often than we ourselves know, is, on the other hand, something secondary, most often resulting from a consciousness of guilt”. ³⁵ And since we have previously excluded the anguish in front of real danger, the “Realangst” (death), it is thus of the other anguish, the “neurotische Angst” (neurotic anxiety), the one in front of a phantasmatic or internal danger that it is about. ³⁶ Where could this neurotic anxiety arise from if not from early childhood? It is indeed the “infantile anxiety” which seems to pave the way for the “adult neurotic anxiety”. ³⁷ Nothing contradictory with this infantile “consciousness of guilt” that Freud will name in another work “social anxiety”, and which was “originally the anxiety of being chastised by the parents, or, more exactly, of losing their love”. ³⁸

This infantile repressed which returns, let's perceive a paradox: an impulsive future without border on the one hand but based, on the other hand, on an ultimate occlusion. An unsolvable cleavage. What Piera Aulagnier summarizes in her formula: “Condemned to invest”. ³⁹ At this point, we wish, in passing, to question the theories of two authors: would it not be appropriate, contrary to Paul-Laurent Assoun, to take advantage of the new approaches to ageing in order to raise the unresolved analytical question of the “post-genital” stage, in the form of a “deconstruction”, a “disorganization” of adult sexuality? In doing so, we also find it difficult to follow Jean Bergeret and his idea of a “latency” of the sexual, of a “desexualization opening for the elderly characters the normal way, sublimations and rationalizations”. ⁴⁰ A questionable idea, it seems to us, since in an article of 1894, Freud takes up the terms of a letter addressed to his friend Fliess a year earlier: with age, he explains, “the libido does not diminish, but there is such an increase in somatic excitation that the psyche is in a state of relative inadequacy to control this excitement”. ⁴¹

Push of the drive, objectal deliquescence

New rupture, a new imbalance between a somatic excitation and an incapacity of elaboration. The very definition of anxiety: “the fact that the development of the Ego lets itself be distanced by the libidinal development is, in our eyes, the essential condition of neuroses”. ⁴² That of all ages is based on “the inadequacy between sexual excitation at the somatic level and the possibility of elaborating this excitation at the psychic level”. ⁴³ “Unused libido” specifies Jean Laplanche about infantile anxiety. ⁴⁴ And he adds: “the real violence that creates anxiety would be this internal violence, this repressed violence, that its own sexual excitation does to the subject”. ⁴⁵ A term that we use in two ways: it is both a “disassignment” in the sense of a detachment - a closed down station, not connected to the rail network - and a disassignment in the sense that, for example, a civil servant on secondment remains on standby for a position and new responsibilities. In our opinion, this semantic duplication reflects both the disorganization of the economic circuits of “facilitation” ⁴⁶ and the absence of “aim”. ⁴⁷

This anxiety is all the more infantile as it originates in the Id, the “great reservoir” of drives ⁴⁸ . An anxiety “reactivated” on the occasion of an event which overflows the mental defences set up for a long time ⁴⁹ , according to Marie-Frédérique Bacqué. If there is an imbalance, it is undoubtedly because of an alteration of the homeostasis, of an unbinding of the forces of which the Ego, where resides the place of expression “displaced of this anxiety” ⁵⁰ becomes the atoning victim.

And as we follow the hypothesis that all the ages of life repeat this inadequacy, this defect of psychic elaboration in front of a somatic excitation, we will venture to affirm that ageing, just like the other great cycles of life, repeats the first inadequacy in the relation between the baby and the adult. Just as the dreams of the adult replicate scenes from childhood ⁵¹ , Freud confirms that “it is moreover still the same situation which was at the foundation of the first great state of anxiety, that of the birth, that of the separation from the protective mother”. ⁵² In this perspective, the fact of holding nostalgia, a recurrent phenomenon in the discourse of the climacteric, as a “defence mechanism against the anxiety of ageing” ⁵³ is not contradictory with the central place of pregenital sexuality: in our patients, the relationship with adults, parents and family circle, constitutes the Gordian knot of their perlaboration. These women carry out a kind of “sexual retrospective” of their existence: the expression must be specified because it does not mean a physical assessment in terms of satisfaction and frustration. Sexual retrospect must be understood as a kind of “travelling”, filmed unfolding of the existence where the infantile psychic sexual provides the prism, making unceasingly return and being used to decipher the whole of the experiences and the later experiences.

Reshuffles and stages of life

Professor Laplanche insists on a fact: the Freudian scheme of the stages is “valid for other barriers and for other stages” ⁵⁴ than the pubertal one. Hence the inevitable “cousinships” between cycles and reshuffles that occur in unpredictable and capricious temporalities: the subsequent patterns between thresholds, crossings and reshuffles resemble those of random successive truths ⁵⁵ whose appearances of irresolution have the value of authenticity.

The typical experiences met in all periods of life, “separation, mourning, pain, various impulses”, are recorded in different ways according to psychic evolution and maturation. Indeed, but an essential fact remains: “the acquired impulse precedes in man the innate instinctual”. ⁵⁶

The problem of reshuffling is put differently: “how to make way for change in a structure that remains unchanged in its constitution”? ⁵⁷ Perhaps it would be advisable to specify: contrary to the puberty which obliges the adult sexuality to make its way and to occupy a place already occupied by the infantile sexuality, the ageing renounces, retrenches, removes. What is the impact on the psychic structure of this “vacuum” made available, if not an increase in tension, an acceleration, an intensification of this “work of self-elaboration always renewed” close to the process of perlaboration defined by Freud as a series of repetitions and recollections? “One is always in the psychic discontinuity on bottom of continuity or reciprocally: there are both” ⁵⁸ explains Cahn. We find the idea previously evoked an oscillation between impulsive push and evanescence, even objectal deliquescence. In the interstice of this switch, a structural modification may occur at the margin. The patients mentioned in the three clinical vignettes could testify to this: a psychic reorganization will indeed take place, but they punctuate it, resistance or confession, with a common: “at my age, I won't change again.” Can we still talk about analysis? We will put forward two arguments in this direction. In this work on the couch, the unconscious, the counter-transference and infantile sexuality were constantly called into play. The analytical work has, moreover, made possible - and perceptible - a “change in the meaning of the subject's relationship to his past” ⁵⁹ . Is this exercise more like an “Aufhebung”, an overcoming, an exit by the top, than an “Erlösung”, a solution, a dilution of the neurotic complex?

What about these patients?

Despite different psychic structures, the analysis will produce for these three patients its effects by displacing, by decentering would it be more exact to write, this research worthy at the beginning of an investigation of Sherlock Holmes. Or that of Miss Marple! There will be no more question of truth: despite undeniable “updates”, notwithstanding the discovery of “clues” and a “reorganization” of the family interweaving, the analysands will carry out on and for themselves a work of “rewriting”, of “overcoming” and, dare we say it, if the word did not have a Christological connotation, an “accomplishment”. ⁶⁰ The one who dreamed of blood-stained sheets, arrives one day with a dream that convinces her that this is probably her last session: the night before, she dreams that she “takes out of her washing machine immaculate and shining sheets that she spreads out to dry in the sun of her garden”: a feeling of happiness overwhelms her. An anxiety too, well known to the analysand approaching the end of the treatment: “will this perception last ?” Ultimate reassurance that it did not belong to the analyst to provide her since she held the key.

For the second, the transgenerational events, a kind of repetition of a family symbolism from the grandmother to the granddaughter, “substantialize” the previously indistinguishable elements of her history. As the sessions progress, the demand will no longer concern the authenticity of knowledge of which the analyst would be the keeper. Net whose meshes will break progressively: the fears will draw their resources more in the digestion than in the confrontation with this truth. Before disappearing: they will be illustrated by a reduction of guilt through the recognition and the post-mortem acceptance of a game all the more seductive towards the social father that this one is deprived of the barrier of the incest. And of a feminine rivalry all the more exacerbated with the mother, this tortuous way guides her towards the “source object” : the real father. The patient will admit the recourse to sadism in the search of phallic power and to help her to build her social authority to avenge the sufferings inflicted by the “two men” of her life. The quest for social distinctions of which the patient is not lacking, however ends up being appeased in sessions where the dose of the horror of her anamnesis gradually takes on the colours of banality. She gradually appropriates her history: “I am a nazi’s daughter”, she will say one day while forbidding the analyst to use this word on his own. Words from the German vocabulary will play the role of a transitional language, of a transferential “bridge”. The patient will admit one day, after having maintained the opposite, “to understand German”, displacement of the “I always knew it” well known to analysts. An acting out marked a turning point: the patient who, until then, had carefully folded and hidden the money for the session in a corner of her purse, forgot it one day at the same time as her identity papers. And to evoke, the following session, her feeling “to have lost his relationship with the analyst.” From now on, the cash will be directly accessible in her handbag.

As for the third analysand, our introduction of the case could suggest a problem far removed from the other two because of the existence of a triggering element. However, after a long plaintive litany on the misfortunes of the obese son of whom, dare we say, the patient has “fed” the sessions, a period begins which allows her to cut the umbilical cord, then to detach herself from her own maternal, to understand the reasons of the family fiasco. She finally wants to “take care of herself”, to indulge herself. Her pleasant dreams of a “house of her own”, which she “arranges as she wants to” even though it is located on a “cliff side”, indicate the qualitative leap that she strives to make in her analytical work. Her clothing is no doubt linked to the transference on the analyst - the good son or the ideal son-in-law? - testify to this: she “finds her suits” about which she wondered “when she could put them back on.” She exhales heavy perfumes, explaining at the beginning of the session: “this is me.”

What do these three fragments of the analysis suggest to us? The analysands evoke the feeling of “relief”, of a “recovered freedom.” Sexualized truth for each of them: the first one gets rid of a sexual ghost, or a sexual fantasy. The second plays on the ambiguity between the attractiveness of social positioning and the maintenance of energetic femininity, surfing on offers from the male. The third “who doesn't want to hear about men anymore” gradually admits that between her father and her son, the place for a “third one might be missing.” She “looks at herself in the mirror again” and “takes aesthetic care of her body.” She decides “to occupy for herself the son's room, rid of the furniture of this last one.”

Each of them illustrates a need to confront her new relationship to knowledge and to the other, integrating a reassurance, notably in this particular relationship maintained with the word of the analyst, structuring the framework: “I had never spoken about it before, you are the first person I confide in” says one. “You at least listen to me”, says the other. The third: “You are my only interlocutor... Who else could I ask for advice?” Does the analytical word act as a “narcissistic stop ?”

We wish to conclude and try to explain this concept of “recovered freedom” as it appears in these psychoanalyses of old age. Some time after having begun her analysis, one of the patients “brings” a dream that disturbs her: “her mother, alive in reality, was dead, well in place in the coffin, quiet and she was astonished in this dream not to feel any sorrow, punctuating this observation with a dreamy word: I enjoyed it well.” And to associate with this dream, not the fear of the disappearance of her mother but what was going to become of her, all that was offered to her, once this one would be gone: “she is everything for me.” As if her mother's presence was simultaneously a barrier to her death and therefore protected her from a field of possibilities, mixing freedom and autonomy. We are certainly not unaware of the “wish fulfilment about the death dream of living persons” ⁶¹ : it is probable that on the occasion of her mother's funeral, the patient aspires to “see her absent son” again. But the overdetermination also leads us to associate with it, an interpretation that the patient will not deny, the revelation of her deadline that joins death and the latitude that remains before reaching it. We remember a woman in her sixties, in excellent health and mourning her mother's death saying: “the next one is me.” One of my other patients, whose father-in-law of more than ninety years had just disappeared, was also astonished by the fact that her husband had this feeling of immensity, this feeling of a space coming before him after the loss of his ascendant. The patient was “surprised” because she had felt, at the time of her parents' disappearance, “a vacuum not in front of her but behind her.” We aim at the problem of any filiation which questions, in a way, in reverse.

The psychoanalysis of old age invites, in order not to be forced to partial destruction of the Ego - the sad renunciations - but only with the aim of “building, from what remains of it, an Ego capable of an even greater resistance.” ⁶² To the three women, it opens the perspective, at the same time distant and close, to apprehend at best these reunions with their phantasmatic “lost object”, substitute of the object in full decay, while exploiting for herself the impulse revival of the enigmatic asymmetry of the first moments of life: to make of the time which remains, a time to be conquered.

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-1- “Do I have a choice between dying and "rearranging" myself”, Journal clinique, Paris, Payot, 1985, p. 284.

-2- « L’élargissement de la conscience est ce qui permet à l’humanité d’exister, de faire face au progrès constant du refoulement » (The expansion of consciousness is what allows humanity to exist, to face the constant progress of répression). Séance de la Société Psychanalytique de Vienne du 10 mars 1909, NRF, Gallimard, 1978, p. 173.

-3- K. Abraham, « Le pronostic du traitement psychanalytique chez les sujets d’un certain âge », Œuvres complètes, tome II, 1915-1925, Payot, Coll. « Sciences de l’homme », 2000, p. 89.

-4- S. Ferenczi, « Pour comprendre les psychonévroses du retour d’âge », Œuvres complètes, tome III, Payot, 1982.

-5- G. Lipovetsky, Le bonheur paradoxal, Essai sur la société d’hyperconsommation, Gallimard, 2006, p. 64.

-6- S. Freud, « Au-delà du principe de plaisir », Œuvres complètes, XV, 1916-1920, PUF, 2012, p. 307.

-7- “Nothing to do with the “three registers of complaint most often presented in the work of aging : chronic use of psychotropic drugs, loss of a loved one, presence of cancer or chronic illness”, Marie-Frédérique Bacqué, « L’angoisse de mort dans le vieillissement, Pratique analytique avec des personnes de plus de soixante-dix ans », in Vieillir aujourd’hui, Le Carnet PSY, n° 180, mai 2014, p. 48.

-8- S. Freud, Notre relation à la mort, Petite Bibliothèque Payot, n° 881, 2012, pp. 51-83.

-9- S. Freud, « Le moi et le ça », Œuvres complètes, XVI, 1921-1923, PUF, 2003, p. 300.

-10- Voltaire specifies that the fear comes from “the idea of death” and not from death itself, B. Craveri, Madame du Deffand et son monde, Points Essais n° 378, Seuil, 1999, p. 263.

-11- K. Abraham, op. cit. p. 86.

-12- “The explanation that I gave to this anxiety is that it is a matter of a sexual excitation which is not understood by the child, is not controlled, which undoubtedly comes up against a recusal because the parents are involved in it, and which, as a result, is transformed into anxiety”, S. Freud, L’interprétation du rêve, PUF, Coll. « Quadrige », 2013, p. 640.

-13- S. Freud, Letter 52 to Wilhelm Fliess dated 6 December 1896.

-14- F. Scholz, « Schlaf und Traum », quoted by S. Freud, L’interprétation du rêve, PUF, Coll. « Quadrige », 2013, p. 47.

-15- B. Brusset, « Un nouveau mode d’existence, parfois le plus heureux », in Vieillir, Des psychanalystes parlent, Erès, 2009, p. 35.

-16- C. Dumézil, « Qu’est-ce que vous appelez l’âge ? », in Vieillir…Des psychanalystes parlent, op. cit., p. 101.

-17- R. Cahn, « Il serait vraiment dommage que je m’arrête maintenant », in Vieillir…Des psychanalystes parlent, op. cit. , p. 41.

-18- E. Kant, Traité de pédagogie (1803), traduction de Jules Barni, Gallica, BNF, p. 89.

-19- M. Moreau-Ricaud, « Grandir jusqu’à la mort ? A propos de M. Balint « The Psychological Problem of Growing Old », in L’Esprit du temps, Topique, n° 93, avril 2005, p. 12.

-20- C.-J. Luquet-Parat, « À propos de quelques psychothérapies de névroses de caractère », Revue Française de Psychanalyse, mai-juin 1968, n° 32, pp. 610-614.

-21- According to the expression of Annie Anzieu, « Est-ce la sagesse ? », in Vieillir, op. cit., p. 22.

-22- M. de M’Uzan, Aux confins de l’identité, NRF, Gallimard, 2005, pp. 42-43.

-23- Nothing to do with the “integrative psychoanalysis” evoked by Otto Kernberg, J.-L. Vannier, « Séminaire de psychanalyse autour d’Otto Kernberg à Berlin », in La psychanalyse en Suisse : une histoire agitée, Le Coq Héron, n° 218, Erès, septembre 2014.

-24- S. Ferenczi, L’enfant dans l’adulte, Petite Bibliothèque Payot, n° 596, 2006, p. 16.

-25- J. Laplanche, Problématiques I, L’angoisse, PUF, Coll. « Quadrige Grands Textes », 2006, p. 17.

-26- A. Anzieu, « Est-ce la sagesse ? » in Vieillir, Des psychanalystes parlent…, op. cit., p. 22.

-27- S. Ferenczi, in Réflexions sur le masochisme, Petite Bibliothèque Payot, n° 871, 2012, p. 33.

-28- S. Ferenczi, « Etre mort, être femme » in Réflexions sur le masochisme, Petite Bibliothèque Payot, n° 871, 2012, pp. 99-104.

-29- R. Dadoun, « Quant au vieillir », in Vieillir, Des psychanalystes parlent…, op. cit. , p. 71.

-30- A. de Mijolla, « Aller vers cette liberté », in Vieillir, Des psychanalystes parlent…op. cit, p. 145.

-31- B. This, « Ceux qui sont entrés en ‘jubilance’ », in Vieillir, Des psychanalystes parlent…op. cit., p. 213.

-32- S. Freud, « Le moi et le ça », Œuvres complètes, XVI, 1921-1923, PUF, 2003, p. 299.

-33- F. Villa, « Quand la psychanalyse rencontre la question du vieillissement », in Vieillir aujourd’hui,op. cit. , p. 21.

-34- S. Freud, « Le moi et le ça », op. cit. , p. 300.

-35- S. Freud, « Notre relation à la mort », op. cit., p. 74.

-36- J. Laplanche, Problématiques I, L’angoisse, op. cit., p. 52.

-37- Ibid. , p. 67.

-38- S. Freud, « Pour introduire le narcissisme » in La vie sexuelle, PUF, 2011, p. 105.

-39- Michelle Moreau-Ricaud, in Vieillir, Des psychanalystes parlent…op. cit., p. 179.

-40- F. Villa, in Vieillir aujourd’hui, op. cit., p. 24.

-41- Letter to Wilhelm Fliess (Manucript E) dated June 1894, S. Freud, Lettres à Wilhelm Fliess, 1887-1904, Edition complète, PUF, 2007, pp. 103-109.

-42- S. Freud, « Abrégé de psychanalyse », Œuvres complètes, XX, 1937-1939, PUF, 2014, p. 298.

-43- J. Laplanche, Problématiques I, L’angoisse, op. cit., p. 32.

-44- Ibid., p. 69.

-45- Ibid., p. 112.

-46- In the sense that Freud uses it in Esquisse d’une psychologie, Entwurf einer Psychologie, Erès, Coll. « Scripta, Ecole de psychanalyse Sigmund Freud », 2011.

-47- S. Freud, « Pulsions et Destins des pulsions », Œuvres complètes, XIII, 1914-1915, PUF, 1988, pp. 163-187.

-48- A. Azar, Le grand réservoir de la libido, traduction française de la Standard Edition, 19, 63-66, par Amine Azar, ‘Ashtarout, Bulletin volant n° 2003.1213 et sa notule complémentaire, in ‘Ashtarout, Bulletin volant n° 2010.1025, Beyrouth, Liban.

-49- M.-F. Bacqué, « L’angoisse de mort dans le vieillissement. Pratique analytique avec des personnes de plus de soixante-dix ans », in Vieillir aujourd’hui, op. cit., p. 47.

-50- S. Freud, « Le moi et le ça », Œuvres complètes, XVI, 1921-1923, PUF, 2003, p. 297 and J. Laplanche, Problématiques I, L’angoisse, op. cit., p. 151.

-51- S. Freud, L’interprétation du rêve, préface de François Robert, PUF, Coll. « Quadrige », 2013, p. 602.

-52- S. Freud, « Le moi et le ça », Œuvres complètes, XVI, 1921-1923, PUF, 2003, p. 301.

-53- A. Azar, « Liminaire pour une approche analytique des climatères masculin et féminin », Cahier hors série n°7 Les figures de la déhiscence, ‘Ashtarout, 2006, pp. 74-101, Beyrouth, Liban.

-54- J. Laplanche, Problématiques I, L’angoisse, op. cit., p. 59.

-55- “It is the unconscious that chooses in accordance with the aims of the interest”, Hartmann quoted by Freud, in an exhaustive footnote, L’interprétation du rêve, op. cit., p. 581.

-56- J. Laplanche, « Sexualité et attachement dans la métapsychologie », in D. Wildlöcher et Al., Sexualité infantile et attachement, PUF, 2000, p. 75.

-57- A. Azar, Défense et illustration des grands cycles de la vie d’un point de vue psychanalytique, Cahier hors-série n°7, ‘Ashtarout, février 2006, Beyrouth, Liban, p. 65.

-58- R. Cahn, « Un désir qui dure », in Vieillir, Des psychanalystes parlent…, op. cit., p. 45.

-59- R. Roussillon, « Du jeu dans la mémoire » in La temporalité psychique, Psychanalyse, mémoire et pathologies du temps, Dunod, 2006, p. 19.

-60- The German “vollbracht” is much more explicit and powerful.

-61- S. Freud, L’interprétation du rêve, op. cit. , pp. 187 et 288.

-62- S. Ferenczi, Réflexions sur le masochisme, op. cit. , pp. 68-69.