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We are all searching for something, perhaps many things. My own career in recent years has been dominated by what I would describe as a search for subjectivity and I have found it in Joseph Palombo’s phenomenal new book, The Neuropsychodynamic Treatment of Self-Deficits: Searching for Complementarity. In it, Palombo offers a comprehensive framework for conceptualizing the interplay between neurobiological, psychological and social factors as they impact subjective experience and development of the self in people with learning disabilities and other types of neuropsychological impairments (including non-verbal learning disorders, executive functioning disorders, attention-deficit hyperactivity disorder, and dyslexia). This book continues Palombo’s legacy of scholarship dedicated to clinical work with neurodiverse clients. As always, the neuropsychodynamic perspective he offers is refreshing given the dearth of analytic theory on this topic. This is a field heavily dominated by behaviorism and skills training approaches, which as Palombo points out have value in resolving specific skill-deficits. However, these approaches do not address the underlying psychodynamics and interpsychic aspects of neuropsychological impairments and how the experience of living with them impacts a person’s sense of self and identify formation.
Integrating conceptual frameworks from self-psychology and nonlinear dynamic systems theory, Palombo observes that underlying neurological challenges can negatively impact a person’s ability to adapt to the demands of their context and are thus experienced as a self-deficit. While people respond differently to self-deficits, Palombo reflects that many experience feelings of shame and humiliation, engaging in defensive processes in order to conceal their deficits from others. He suggests that those who are successful in
overcoming these dynamics often find relationships where they can engage in mindsharing, whereby another person is able to compleme