NEGLECT AND ANOSOGNOSIA A CHALLENGE FOR PSYCHOANALYSIS. PSYCHOANALYTIC TREATMENT OF NEUROLOGICAL PATIENTS WITH HEMI-NEGLECT

Neglect and anosognosia, i.e., the denial of the (left) hemisphere and the denial of hemiplegia, are often found in patients suffering from damage to the right hemisphere of the brain. It has been known for some time that these symptoms can be alleviated, albeit temporarily, using various methods, (Ramachandran, 1994; 1996; Ramachandran & Blakslee, 1998). Kaplan-Solms and Solms (2000) found that in psychotherapeutic interviews patients could also become temporarily aware of their formerly denied lesion. They concluded from their research that the purpose of the neglect-syndrome is a defence against denial. For the past four years, the Neuropsychoanalytic Study Group Frankfurt/Cologne has conducted psychoanalytic therapy with a group of patients with right hemispheric lesions, all exhibiting neglect/anosognosia. Results so far indicate that defence against depression is not the only cause of the syndrome, but that failure to construct a body schema, as a result of the paralyzed side of the body no longer being represented is also involved. Patients appear to refer to memorized representations resulting in so-called ‘neglect-syndrome’. Recent research (Craig, 2002) lends support to this view. Preliminary hypotheses concerning the interaction between neuroscientific models and psychoanalytic concepts are discussed and illustrated with a case vignette.

Resistance as a measure of the duration of the psychoanalytic cure

The author considers the role of resistance in analysis and asks specifically if the resistance of the analysand can be considered a measure of the duration of analytic treatment. It is not in any objective sense, but several indications in Freud’s and Lacan’s work indicate that they do draw connections between resistance and the duration of the treatment. Freud’s definitions of resistance are explored as well as several discussions of resistance in Lacan’s early, middle, and later work. Ultimately, Lacan shifts from a notion of the resistance of discourse to one of the resistance of structure—the topological structure of the Borromean knot.