Two accidents – one survivor: Neurological and narcissistic damage following traumatic brain injury

Abstract

In this paper, the author presents an account of her work in an NHS Rehabilitation Service. This is followed by a case study of psychotherapeutic work, over a period of 18 months, with a man in recovery from a head injury. She makes the point that the internal response to neurological and physical injuries, in some patients, can produce narcissistic as well as cognitive injuries. All of these factors, together with the patient's internal response to the traumatic event, need to be addressed.

The theoretical and clinical approach taken is one of a psychoanalytically informed understanding of the traumatic event. In the course of working with the patient, Mr A, he uncovers links to a previous trauma in his life which he had not been able to come to terms with, and which the author suggests was reactivated by, the more recent trauma of the head injury.

Keywords:

• Neurological damage
• narcissistic damage
• head injury
• trauma
• rehabilitation