Sex and death: the ramifications of illness and aging in older couple relationships

Family therapy has long been the traditional psychological model with which to treat problems in later life; particularly depression and dementia, but also some physical illnesses. In more recent years however, a growing interest in couple therapy has been seen, and this has been linked to some extent with a burgeoning enthusiasm for psychodynamic psychotherapeutic principles as applied to older people. A number of psychoanalytic models are quite helpful when addressing the problems of ageing and loss in old age. Theories about Narcissism and those that address Object Relations particularly, can be used to view the changing dynamics within an elderly couple. These and other theoretical frameworks are elucidated and ‘illustrated’ with composite clinical material. This paper also examines some of the non-medical model understanding of late life depression within the context of intimate partnerships. Treatment models involving the couple are discussed, including the use of a Couples' group. Same sex partners...