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:: Discussion Forum
:: The neuropsychoanalitic experience in the clinical pratice
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| The neuropsychoanalitic experience in the clinical pratice |
Posted by polianalorena on 09/01/2005 02:38
I have been working with behavior disorders in Alzheimer patients. For my surprise the neuropsychonalitical approach have been done a great contributions in my clinical pratice. What I call as neuropsychoanalitical aproach is to see the patient and the disease not just a chemical or structural process but to see the patient with a past story and repressed content that could to contribute with the personality change or others behavior disorders in these patients. NOw, I have been studying about anosognosia in Alzheimer patients. Why some AD have anosognosia and others not? Could be possible to think about narcisism in these cases?
Please, your opiniou will be very helpfull for my research.
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| Re: The neuropsychoanalitic experience in the clinical pratice |
Posted by polianalorena on 09/01/2005 02:42
My name is Silvia Laurentino and I presented a oral presentation in Rio congress about Alzheimer and behavior disorders
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| Re: The neuropsychoanalitic experience in the clinical pratice |
Posted by Michael Harvey on 09/29/2005 03:35
I have also assessed and worked with individuals in varying stages of Alzheimer's type dementia from a neuropsychoanalytic frame. There are both dynamic and neurological reasons for this kind of phenomenon. The dynamic issues would very much involve the vulnerability of a person to what Freud spoke of as amentia, or acute confusional psychosis, due to the need of the ego to deny the loss of its most precious organ that is affirmed in reality. If you review Freud's Metapsychological Supplement to Dreams you will find much of value packed into this paper which will illustrate the reason reality is repressed in such cases.
Typically, Alzheimer's begins in the left temporal lobe and progresses more rapidly through the left mesial temporal area and more anterior aspects of the left hemisphere than in the right hemisphere which over time also becomes involved. This pattern holds for about 60% of cases. About 40% of cases of Alzheimer's exhibit an atypical progression - again, initially starting in the left temporal region with a more rapid progression from the right temporal-parietal to anterior aspects of the right hemisphere than on the left.
Dynamically, it is very important to consider what the loss of a particular ability has for the individual involved and the extent to which they are able to tolerate and acknowledge awareness of this loss.
In addition, neuropsychologically, greater progression of the disease in the right hemisphere - the atypical pattern - ought to be a set up for a greater degree anosognosia.
I would refer you to Solms and Solms, Explorations in Clinical Neuropsychoanalysis and the sections on right hemisphere damage for an explication of the dynamics involved in fantasies of having died followed gradually by a very deep depressive reaction which initially was denied.
Mike
Michael Harvey, Psy.D.
Director of Neurorehabilitation
LifeQuest
Sheridan, WY
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| Re: The neuropsychoanalitic experience in the clinical pratice |
Posted by peter todd on 10/08/2005 08:20
I believe that it may be fruitful to conceptualize dementing illnesses and other neurological disorders as representing major narcissistic injuries to which psychoanalytic techniques can be applied in much the same way as is possible with other traumatic object losses. Such losses of course, are not only of highly emotionally cathected bodily organs and functions, but also potentially of significant relationships with persons, work related institutions and so on.
This is a perspective which I have brought to research and therapy with persons diagnosed with such immunologically mediated and resisted diseases as (breast) cancer, HIV/AIDS and autoimmune disorders in which patients experience the threat of bodily and self disintegration with correspondingly powerfully painful and "primitive" affects such as shame and rage (whatever may be happening in the amygdala and limbic system?)
Not surprisingly perhaps, my experience over the years working within an analytically oriented framework, has been that the diagnosis and onset of such diseases usually revives repressed and unresolved issues over early object relationships and attachments as well as libidinally/emotionally cathected body parts and functions. Such material would not lend itself to short term solution focussed or cognitive therapies which ignore the unconscious.
The neuropsychoanalytic approach can facilitate the empirical understanding of such psychoanalytic formulations and their neural correlates while permitting a more profound evaluation of therapeutic processes and outcomes.
Peter Todd,
Sydney, Australia.
Edited by peter on 10/08/2005 08:43
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