ABSTRACT
The literature on analytic approaches to neuropsychiatric cases is highly varied. One of the major problems psychotherapists face with neurological patients is that the alteration in the sense of self co-occurs with varying cognitive limitations in the ability to comprehend and emotionally work through the fact of damage. The chapter discusses three elements effecting psychoanalytical interventions with brain injured patients: premorbid factors that effect outcome and technique, general analytic treatment goals, and specific analytic treatment approaches which can be tailored to the needs of particular patients. Psychoanalytic assistance is most useful before clinical situations reach the levels of crisis or stalemate. Social, emotional, cognitive, and biological issues are interwoven in each story of human suffering. The psychoanalyst needs to be thoughtful about finding specific ways to help assuage the pain and promote healing. Psychotropic, neuroleptic, antidepressant and other medications may further assist dramatically in reducing emotional extremes and enhancing learning.
