A PSYCHODYNAMIC MODEL OF BEHAVIOR AFTER ACUTE CENTRAL-NERVOUS-SYSTEM DAMAGE

This article describes a conceptual psychodynamic model for understand ing the neurobehavioral manifestations of acute central nervous system damage (ACNSD) displayed by patients during the rehabilitation proces s. According to the proposed model, patients' behavioral responses are viewed as their only means of emotional expression and therefore may not be considered entirely abnormal when viewed from the perspective o f patients' interpersonal contexts. An improved understanding of the d ynamic processes through which recovering patients with ACNSD journey may lead to better interaction between the patient and the therapeutic environment, the interdisciplinary team, and family members. Combinin g this proposed psychodynamic model with an emerging understanding of the neurobehavioral foundations of aggression and depression may also lead to a more rational approach to intervention with various psychoph armacologic agents. During the rehabilitation process, understanding p atients' cognitive deficits, motivational drives, and emotional needs and proper implementation of medical and environmental treatment can u ltimately lead to a better psychosocial outcome.