ABSTRACT
This chapter suggests that psychodynamic insights into a patient's psychological development prior to their brain injury – methods of coping with anxiety, attitudes toward parental figures, and personal motivational goals. It illustrates how psychodynamic insights can help guide psychotherapeutic interventions with persons who have severe traumatic brain injury (TBI), which results in a meaningful reduction of their disability and social handicap. While psychodynamic psychotherapy encompasses many other features, it does stress the importance of the therapeutic alliance or bond. Psychodynamic approaches to psychotherapy have always emphasized the therapeutic value of self-reflection—that is, the person observing their own personal reactions, thought processes, and ways of behaving. The value of dreams in understanding the patient's experience has become obvious, particularly as a tool to access aspects of the patient's experience that are not verbalized during psychotherapy. Psychodynamic psychotherapy focuses on individuals' personalities and how their reactions to the brain disorder impact relationships with others and attitudes about work.
