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One of the most valuable things about neuropsychoanalysis is the way in which the “vehicles” of our dialogue – neuroscientific and psychoanalytic ideas and data – shine new light in both directions as they drive the now rather wide highway emerging between the two domains. Neurological observations illuminate theoretical propositions from psychoanalysis; likewise, psychoanalytic concepts and rich clinical wisdom create new points of contact with neuroscientific research. The pieces in this issue of Neuropsychoanalysis all exemplify this trend in various ways.
In their article “The Impact of Traumatic Brain Injury on Awareness and Mourning: the Role of Concrete Behavior,” Christian Salas and Rudi Coetzer travel this neuropsychoanalytic highway in both directions with nuance and range. They discuss the frequent presentation of concrete behavior in patients who have survived traumatic brain injury (TBI); this concrete behavior seems to arise from damage to circuits which mediate memory and prediction, so that patients are left in a vivid here-and-now with diminished capacity to reflect, and at the same time seem to have an impaired capacity to mourn, which often impedes the process of adjusting to their new circumstances. Clearly the dysregulation of brain and mind are interwoven here: the underlying circuits required for reflection and grieving may be structurally affected, and at the same time the psychodynamic need to protect the self from the pain of loss may be magnified by the very loss the person has suffered.
Salas and Coetzer also remind us about a use of the term “default mode” in behavioral neurology that is almost completely opposite its current sense in the emerging literature on “resting state” brain networks. With this term, Mesulam (2002) described a mode of concrete, here-and-now functioning that predominates when the capacity for abstraction is impaired following damage to certain cortical functions. Mesulam's meaning stands in intriguing contrast to t