Chapter 17 A Disorder of the Self in an Adult With a Nonverbal Learning Disability

Kohut (1971) stated that a disorder in which the deficit is clearly identified can be instructive in clarifying the function the missing element performs in healthy individuals. This construct, which appears to have been borrowed from neurological research, is applicable to the patient I am about to present. This patient suffers from a nonverbal learning disability (NVLD). NVLD is a neurologically based disability that manifests in, among other things, an impairment in the capacity to communicate nonverbally and also interferes with the capacity to form relationships with others. The deficits, which are in the visual—spatial area and in the area of processing social cues, interfere with the reception, expression, and processing of nonverbal signs. In many patients, a disruption occurs in the dialogue with caregivers during development resulting in a disorder of the self. The selfobject deficits that arise often lead to narcissistic personality disorders or to more pathological personality formations. Studying the dynamics of these patients can be instructive to clinicians in several important ways. They can shed light on the effects neuropsychological deficits have on the