Neuropathologies of the Self: A General Theory with Todd Feinberg at NYPSI

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THE NEW YORK PSYCHOANALYTIC SOCIETY & INSTITUTE:

Arnold Pfeffer Center for Neuropsychoanalysis
247 East 82nd St., between 2nd & 3rd, NY, NY, 10028
Saturday, February 5, 2011
10 am – 12 pm
Todd Feinberg, M.D.
Professor of Neurology & Psychiatry, Albert Einstein College of Medicine
Chief of the Yarmon Neurobehavior & Alzheimer’s Disease Center of Beth Israel Medical Center

Neuropathologies of the Self: A General Theory 
Discussant: Mark Solms, Ph.D.

The neuropathologies of the self (NPS) are disorders of the self and identity that occur in association with brain pathology and include perturbations of the bodily, relational, and narrative self. Among the NPS are included Somatoparaphrenia (misidentification and delusions about a paralyzed left limb), Delusional misidentification syndromes (DMS) such as Capgras syndrome for the mirror image (selective denial of the identity of the self in the mirror) and Delusional companion syndrome (fantasy of a fictitious other). Right, especially medial-frontal and orbitofrontal lesions, are associated with these conditions. The ego disequilibrium theory posits that specific brain pathology causes a disturbance of ego boundaries and functions and the emergence of developmentally immature styles of thought, ego functioning, and psychological defenses including denial, projection, splitting, and fantasy that the NPS patient have in common with the child. I hypothesize that during brain development between approximately ages 3-7 immature defensive functions and fantasies tend to be replaced by mature defenses and the inhibition of fantasy –  a process that depends upon maturational processes within the right hemisphere. In this lecture I will show tape of some classic NPS, and present a four-tiered model of the NPS that emphasizes a multifactorial approach and includes both negative and positive, bottom up and top down, and neuropsychological and psychological factors.

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