ABSTRACT
Patients with neurological damage face many personal and social losses, and certain cognitive problems can further complicate the process of emotional adjustment - normal mourning. Freud (1923b) posited that it is the auditory-verbal element of words that is crucial to reliably bringing thoughts into conscious awareness, a key mechanism of change in psychotherapy and emotional adjustment. Solms (2013) also suggested the importance of syntax in language in enabling humans to think about things in time and in space. Building on previous case studies in aphasia by Kaplan-Solms and Solms (2000), this case study explores the impact of syntactic changes in a patient with Luria’s semantic aphasia. The case illustrates the importance of considering the effect of receptive syntactic changes on the patient’s ability to make meaning, with implications for engagement in psychotherapy and normal mourning. Moreover, this case brings into focus the role of receptive language ability in maintaining reflexive consciousness. Also highlighted is the utility of countertransference as a source of data in clinical assessment with neurological patients, some limitations of a cognitive understanding of receptive aphasia, and how incorporating these variables into case formulations can guide simple adjustments to facilitate psychotherapeutic goals.
