We agree about the metaneuropsychology of the ego (but not so much about the superego): A commentary on “Revisiting the left convexity hypothesis: Changes in the mental apparatus after left dorso-medial prefrontal damage” by Salas & Yuen

Abstract

I agree with the majority of the conclusions of Salas and Yuen concerning the metaneuropsychological functions of the left dorsolateral prefrontal convexity, which interpolates thinking (and therefore inner speech) between instinct and action. This is because I see the case described by them as supplementing rather than “revisiting” or “revising” our hypothesis regarding the left prefrontal convexity [Kaplan-Solms, K., & Solms, M. (2000). Clinical studies in neuro-psychoanalysis. London: Karnac], which concerned Broca’s area rather than the left frontal convexity as a whole. I only find myself in disagreement with them when they describe the superego features of their case. I think the apparent superego deficits they describe are actually ego deficits, caused by changes in the ego’s capacity to mediate superego demands. I elaborate on the dynamic localization of the superego, the supposed “head” of the ego, which is actually more deeply rooted in the mental apparatus than the bodily ego is. It is in fact extremely difficult to distinguish between ego and superego in topographic terms, as Freud acknowledged when he first introduced the concepts.

Keywords:

• left dorsolateral prefrontal convexity
• ego
• superego
• inner speech
• localization
• Freud
• Luria

Disclosure statement

No potential conflict of interest was reported by the author.

Supplemental data

Supplemental meterial of this article can be accessed at http://dx.doi.org/10.1080/15294145.2016.1239051

Notes

1. In fact, I cannot agree with the authors’ characterization of his lesion as watershed infarction (which would affect only the regions supplied by terminal branches of the anterior and middle cerebral arteries). Although oddly patchy, the lesion clearly also affects regions supplied by the trunks of these arteries, including the left temporo-parietal convexity. It is also noteworthy that he was born left-handed. He is in many respects an unusual case, as indeed were the cases of Luria’s cited by Salas and Yuen (2016, pp. 3–4). Luria’s cases were patients with penetrating missile wounds, which are not easily localizable, but the sites of their lesions differ dramatically from those associated with the classical aphasic syndromes seen with typical CVAs of the left anterior circulation.