The Historical Influence of Psychoanalytic Concepts in the Understanding of Brain Injury Survivors as Psychological Patients.

Since the early work of Goldstein (1954, 1995), psychoanalysis has been an influential theoretical and clinical perspective in comprehending our patients' emotional adjustment after brain injury. This, even though psychoanalytic mainstream has considered for decades “organic” patients as the paradigmatic example of contraindication (Cooper and Alfille, 2011). The relationship between psychoanalysis and neuropsychological rehabilitation, the discipline specialized in helping brain injured survivors adjusting to physical, cognitive and behavioral problems, has been equally complex (Salas, 2014). Leading authors of the field have questioned whether psychoanalytic psychotherapy is suitable for this population and whether unconscious processes and early relationships have any relevance in rehabilitation (Wilson, 2014). In this opinion article I will argue that psychoanalysis has strongly influenced the way in which psychologists, clinical neuropsychologists and rehabilitation professionals understand brain injured survivors as patients with important psychological rehabilitation needs. I will briefly summarize four key psychoanalytic ideas that have contributed to the development of neuropsychological rehabilitation.