Abstract
The neuropathologies of the self (NPS; Figure Figure1)1) is a proposed broad grouping of various syndromes in which the common factors are that a demonstrable focal brain lesion(s) or dementia causes an alteration in the patient's personal identity or personal relationships between the self and the world. The NPS may include many conditions (some of which are highlighted in the Figure Figure1)1) but some of the better known are the delusional misidentification syndromes (DMS; Capgras and Fregoli syndromes, DMS for the mirror image); somatoparaphrenia; and phantom boarder syndrome (Feinberg, 2001, 2009a,b, 2010, 2011a; Feinberg et al., 1999; Feinberg and Keenan, 2005). Figure 1 Based upon Feinberg (2010, 2011a); Vaillant (1977, 1992, 1993) and Cramer (1991, 2006). On the left is a hierarchical four-tiered model of representative factors contributing to some of the neuropathologies of the self. Some cognitive (level 1) deficits ...
Highlights
The neuropathologies of the self (NPS; Figure 1) is a proposed broad grouping of various syndromes in which the common factors are that a demonstrable focal brain lesion(s) or dementia causes an alteration in the patient’s personal identity or personal relationships between the self and the world
The NPS may include many conditions but some of the better known are the delusional misidentification syndromes (DMS; Capgras and Frégoli syndromes, DMS for the mirror image); somatoparaphrenia; and phantom boarder syndrome (Feinberg, 2001, 2009a,b, 2010, 2011a; Feinberg et al, 1999; Feinberg and Keenan, 2005)
A HIERARCHICAL MODEL OF THE NPS The NPS differ from purely cognitive disorders in that the mistaken beliefs in NPS are more delusional, personally idiosyncratic or bizarre, more influenced by the patient’s motivations and personal relationships, and less tied to a specific domain of neurological impairment
Summary
Neuropathologies of the self and the right hemisphere: a window into productive personal pathologies. While levels 1 and 2 are comprised of negative factors that are based upon cognitive and functional impairments— functions that the brain is not doing or cannot do—on level 3 we find productive, motivational, and defensive positive factors—that is processes that the brain is doing and can do, often in response to levels 1 and 2 deficits that often serve as precursors. On this level psychological defenses—processes that are based upon psychodynamic and psychoanalytic theories (Vaillant, 1977, 1992, 1993)—are important. These are followed by projection and fantasy that are considered “immature defenses” because they make
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