The Aging Trauma Therapist Treating an Aging Caseload

Abstract
As clinical psychologists, psychotherapists and psychiatrists age, many of us choose to practice much longer than other professionals. The sedentary nature of the work allows us to continue to use our wealth of experience in the service of helping others. As we age, many of us find ourselves treating aging patients. The advent of telemedicine has made it easier for us to see patients and for them to see us despite mobility issues. Perhaps we have been treating them for many years and thus have aged together. Others have come to us more recently as they sought out an older clinician whom they felt would better understand the issues that trouble them. These older patients might be trauma survivors with or without a dissociative disorders diagnosis. They may have come to us for anxiety, depression or adjustment to changes in the life cycle such as ill health, death of a spouse, or loneliness when retired or adult children live far away. Helping them navigate these changes may force us, whether consciously or not, to face our own. When we do so, and judiciously share some of these as we feel appropriate, we can be of great help to our older patients.

Drs Maves and Hochberg have been treating some of their patients for decades. We discuss the effects of our work with them as we come to grips with our own aging process, such as losing loved ones or facing health crises. We discuss the challenges some of our aging patients face as cognitive abilities begin to decline and they or others question whether or not they are developing dementia. Both clinicians have been treating trauma and the dissociative disorders in particular for many years. Both no longer accept new strictly DID patients. Dr Maves engages in forensic cases and provides consultation to other clinicians treating dissociative patients. Having lost her husband to Alzheimer’s disease, Dr Hochberg now also treats couples where one spouse has been diagnosed with dementia, works with the bereaved, and provides consultation to younger clinicians treating dissociation. During the COVID pandemic, she undertook certification as an end-of-life doula to assist the dying and their families prepare for death.

This workshop will cover the recent literature on treating the older patient, and on the older therapist. We will also address the differential diagnosis of dissociation and dementia in the older patient. Each of us will discuss what we have dealt with in the past and at this time in our practice lives. There will be ample time for questions and comments.