What Every Psychoanalyst should know about Minimal Brain Dysfunction

From my first encounter with her, I concluded that meaningful conversation with this patient would be extremely difficult. Her speech rate was so rapid that it was hard to keep up with and register all she was saying. Interrupting was her typical pattern. I never had the feeling that she listened to more than a fragment of what I said to her. I cannot count the number of times I said to her, “I don't think you've heard one word of what I've just said” or “What did I just say to you?” Her ability to put herself into the position of others was practically nil. Her insight into the way she appeared to others was almost nonexistent. It was not surprising that she had no friends, so insensitive was she to the feelings of others, so ignorant was she of many of the elementary principles of acceptable social behavior. Basic rules of logic seemed to be beyond her comprehension and I could not convince her of the illogicality and inconsistency of many of her statements. Yet her command of the English language was certainly adequate and most would not have considered her to be of less than average intelligence.

The patient was 48 years old. Actually, she was not strictly speaking a patient of mine; rather, she was being seen in counseling as part of the treatment of her 13-year-old son, Jim, who exhibited many signs and symptoms of the kind of neurologically-based learning disability commonly referred to as minimal brain dysfunction (MBD). The above description of his mother applied to Jim at every point. He spoke rapidly, interrupted frequently, and rarely listened to what was being said to him. In school, he blurted out answers to his teachers' questions and rarely raised his hand and waited until he was called upon. Sharp criticism by