Implications of a neuropsychoanalytic formulation in the psychodynamically-oriented psychotherapy of a non-neurological patient

摘要

Neuropsychoanalysis is an interdisciplinary field that integrates neuroscience and psychoanalysis. Recently, a neuropsychoanalytic approach to clinical practice has been introduced by Mark Solms. The neuropsychoanalytic clinical formulation is based on identifying the main unmet basic emotional needs throughout the patient's life, the predictions that have been generated in an attempt to meet those needs, and the defenses that have developed to deal with the sufferings resulting from these faulty predictions. The psychotherapeutic process is aimed to modify inefficient predictions via working through various manifestations of these predictions. The current clinical report presents implications of a neuropsychoanalytic formulation in the psychotherapy of a non-neurological patient in his late thirties. The patient's background, as well as the treatment process and the transferential and counter-transferential dynamics, led to identifying PLAY as the main unsatisfied emotional need. Lack of PLAY compromised the patient's ability to handle other emotional needs, especially PANIC/GRIEF. Manipulation, emotional pressure, and blurring the other's needs were the themes that characterized the predictions the patient used in handling the unmet need. These faulty predictions resulted in suffering and frustration. Interpretations derived from that conceptualization and their influence on the patient and the treatment process are reported in this paper.