Psychodynamic Factors of Recovery After Brain Injury: A Role for Defence Mechanisms?

Brain injury may cause serious motor, cognitive, and affective sequelae that significantly affect individual’s functioning, interfering with his/her autonomous living. Psychopathology and maladaptive coping styles are frequently observed in these patients and are associated with poorer physical, occupational, and social outcomes. Psychological reactive mechanisms and premorbid cognitive–affective coping style are reported to play a significant role in the patient’s recovery processes. Among these, mechanisms of psychological defence such as repression/denial may be active in patients that, after brain injury, show emotion/affective dysregulation and tend to use less efficient coping strategies. Moreover, repression/denial could influence the patient’s ability to correctly acknowledge the illness and its consequences, in so way hampering his/her productive participation to the rehabilitative programme and social reintegration. In this paper, we discuss the possible role of psychodynamic mechanisms in the recovery after brain injury, with the aim to provide some clues for the purpose of the clinical intervention.