Editors' Introduction

The content of the Target Article, “Neuropathologies of the Self: A General Theory,” by Todd Feinberg, really goes to the heart of neuropsychoanalysis as it was originally conceived. It is not simply the study of the brain at the neuroscientific level in order to explain psychological phenomena at manifest high levels of function. It is the study of syndromes in which there is a multilevel interaction between brain disorders and psychodynamic phenomena, producing a describable neuropsychodynamic syndrome. For instance, in Capgras syndrome, patients believe that a close person (often a spouse), or a place, or an object has been substituted for by an impostor and that they are living in the company of this false other. It is not a brief misidentification: it is a conviction that is completely resistant to argument. Following the brain lesion, we see a form of perceptual disorder affecting the boundaries of the subjectively held self, with a projection of this self-dislocation onto the other, a large subjective shift undermining the sense of self, and regressive defenses to organize the new, radically distorted reality. One can appreciate already the intertwining of neurology and psychodynamics.

In this example of one of the syndromes, we see Feinberg using several bodies of knowledge, including an understanding of brain defects that goes back to the nineteenth-century neurologists. Then he makes extensive use of Hughling Jackson's multileveled model of brain function, including the division of symptoms into negative (loss of a brain function) and positive (release of functions previously inhibited in the process of maturation from childhood), generating a number of pathologies. Feinberg also utilizes basic psychoanalytic models of development, particularly those of Sigmund and Anna Freud and George Vaillant, to depict levels of defense from the primitive to the most mature, developing an approach—the ego-disequilibrium model—to describe many of the differ