Good actors bring so much to a scene that could easily get tagged as clichéd otherwise.
Notice the camera placement and the dialogues.
They are there for Burstyn to let loose. Nothing else.
Once the monologue begins, all you see is her and her alone.
And it makes one tear up from the inside. Because she is able to reach a part of you that has the same fears about the future and the same disappointments about the past as her character.
You could be sixty while you're watching this, or you could be twenty, or somewhere in between.
The despair seeps through.
PS: Scene from Aronofsky's disturbingly psychedelic Requiem for a Dream. Catch trailer here.